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Frequency distribution of modified Cormack-Lehane views-A retrospective audit of tracheal intubation in children with normal airways

Schmid, Kathrin; Buehler, Philipp Karl; Schmitz, Achim; Both, Christian P; Weiss, Markus (2019). Frequency distribution of modified Cormack-Lehane views-A retrospective audit of tracheal intubation in children with normal airways. Acta anaesthesiologica Scandinavica, 63(8):1001-1008.

Abstract

BACKGROUND: Paediatric patients with an unanticipated poor grade of laryngoscopic view during tracheal intubation represent a challenging situation potentially associated with increased morbidity and mortality. The aim of this study was to investigate the frequency of modified Cormack-Lehane (MCL) views and to elucidate variables for poor views in a large collective of children without anticipated airway difficulties.
METHODS: The departmental anaesthesia patient database was searched for patients who had undergone general anaesthesia with tracheal intubation between January 2007 and March 2017. Inclusion criteria were age from birth to 17.99 years, general anaesthesia with tracheal intubation using direct laryngoscopy, no history, symptoms or signs of a difficult airway and the best obtained MCL view documented in the database. Patient- and anaesthesia-related variables associated with a poor view (MCL IIb, III and IV) were elucidated using a logistic regression model.
RESULTS: In all, 22 965 patients were included; of these, 17 593 were observed only once. The prevalence of the first observed MCL views I, IIa, IIb, III and IV was 90.6%, 8.5%, 0.86%, 0.05% and 0%, respectively. The logistic regression model indicates that age and gender are the most important variables associated with MCL views IIb and III in the model. The probability for MCL views IIb/III decreases across the first 5-7 years before increasing again.
CONCLUSIONS: The incidence of a poor grade of laryngoscopic view was found to be very low in children with a normal airway. They mainly occurred in infants and adolescent patients and were more common in male patients.

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of Intensive Care Medicine
04 Faculty of Medicine > University Children's Hospital Zurich > Clinic for Surgery
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Anesthesiology and Pain Medicine
Language:English
Date:September 2019
Deposited On:25 Oct 2019 07:41
Last Modified:22 Oct 2024 01:36
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:0001-5172
OA Status:Closed
Publisher DOI:https://doi.org/10.1111/aas.13387
Related URLs:https://www.zora.uzh.ch/id/eprint/232459/
PubMed ID:31162669

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