Predictive value of anatomically difficult airway tests

Abstract

Introduction: the treatment of the airway is important in the care that involves the practice of the Specialist in Anesthesiology, the prior identification of the patient with an anatomically difficult airway is a priority. Objective: to determine the sensitivity and specificity of the different tests for anatomically difficult airway. Methods: a descriptive, cross-sectional and prospective study was carried out with quantitative-qualitative methods in 3,520 patients over the age of 19 of both sexes who received endotracheal general anesthesia for elective or emergency surgery at the "Arnaldo Milián Castro" Hospital from February 2018 to February of 2019. Several predictive tests were used and applied in the immediate pre-operative period. The history of anatomically difficult airway, the presence of signs of upper airway obstruction and difficulty in mask ventilation were specified, and the degree of difficulty of laryngoscopy was determined. Results: the incidence of difficult intubation was 1%, the increase in body mass index, signs of upper airway obstruction and difficult mask ventilation were significantly related to difficult intubation. Predictive tests showed high specificity and a high negative predictive value but low sensitivity, the interdental distance revealed the highest sensitivity and the movement of the atlanto-occipital joint the highest positive predictive value. Conclusions: predictive tests revealed high specificity with low sensitivity and a directly proportional relationship between anatomically difficult airway and the number of predictive tests with positive results.

Keywords

• laringoscopía
• intubación
• valor predictivo de las pruebas