Comparação de diferentes testes para determinar intubação difícil em pacientes pediátricos

Abstract

BackgroundThe difficulties with airway management is the main reason for pediatric anesthesia‐related morbidity and mortality. ObjectiveTo assess the value of modified Mallampati test, Upper‐Lip‐Bite test, thyromental distance and the ratio of height to thyromental distance to predict difficult intubation in pediatric patients. DesignProspective analysis. Measurements and resultsData were collected from 5 to 11 years old 250 pediatric patients requiring tracheal intubation. The Cormack and Lehane classification was used to evaluate difficult laryngoscopy. Sensitivity, specificity, positive predictive value and AUC values for each test were measured. ResultsThe sensitivity and specificity of modified Mallampati test were 76.92% and 95.54%, while those for ULBT were 69.23% and 97.32%. The optimal cutoff point for the ratio of height to thyromental distance and thyromental distance for predicting difficult laryngoscopy was 23.5 (sensitivity, 57.69%; specificity, 86.61%) and 5.5cm (sensitivity, 61.54%; specificity, 99.11%). The modified Mallampati was the most sensitive of the tests. The ratio of height to thyromental distance was the least sensitive test. ConclusionThese results suggested that the modified Mallampati and Upper‐Lip‐Bite tests may be useful in pediatric patients for predicting difficult intubation.