Identification of Patients With the Risk for Difficult Tracheal Intubation in the Intensive Care Unit

Abstract

Background: Aims: Identification of patients at risk for difficult visualization of the larynx (DVL) using Hyomental distance ratio (HMDR) in adopting an alternative strategy for intubation at intensive care unit. Settings and Design: Haemodynamicaly stable unconscious patients with GCS <8 admitted in intensive care unit requiring intubation.  Subjects and Methods: A scale was put on to the surface on the skin near to  hyoid bone, and distance from point near mentum to  hyoid bone measured and was taken as the Hyo-mental distance (neutral position) and measurement  taken by extension method and ratio  calculated. After intravenous induction followed by paralysis,vocal cords were visualised  and assessed with Cormach and Lehane method (C&L) classification. Statistical analysis: Done using students ‘t’ test and chi-square test. Results: The highest sensitivity 26.30% observed in predicting DVL was with HMDR (26.30%). Conclusion: HMDR is a good and reliable predictor of DVL to certain extent , because of its higher specificity and negative predictive value.