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April 7, 2019Journal of Head & Neck AnesthesiaOpen Access

A retrospective analysis of factors associated with difficult endotracheal tube passage with use of the hyper-angled GlideScope blade

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Authors

SSSamuel A. SchechtmanUniversity of MichiganMMMichael R. MathisHeart Failure & TransplantGMGeoffrey MullerUniversity of Arkansas for Medical Sciences

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Implication

Retrospective cohort study reveals predictors of difficult tube passage in adults, highlighting procedural risks with hyper-angled blades.

Key Points

  • To identify patient characteristics and procedural factors linked with difficult or failed endotracheal tube passage during intubation using a hyper-angled GlideScope blade.
  • Conducted a single-institution retrospective cohort study of N=6,109 adult intubations using a hyper-angled GlideScope blade.
  • Categorized tube passage as easy (T1), difficult (T2), or failed (T3), evaluating difficult/failed passage as the primary outcome.
  • Identified independent predictors using nonparsimonious logistic regression with 1,000-sample bootstrapping, including a subgroup analysis of head and neck surgical cases.
  • Easy endotracheal tube passage occurred in 5,412 (88.6%) patients, difficult passage in 666 (10.9%), and failed passage in 31 (0.5%).
  • Limited glottic view (grades 2a, 2b, 3, and 4) and short thyromental distance (<6 cm) independently predicted difficult or failed tube passage.
  • The absence of teeth and standard tube sizes (6–8) were protective, whereas laser-safe tubes independently predicted difficulty or failure in head and neck procedures.

Cite This Study

Schechtman et al. (2019) studied this question.

synapsesocial.com/papers/6a85a103a46f793aa75e34c2https://doi.org/10.1097/hn9.0000000000000014
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