Comparison of Mallampati test with lower jaw protrusion maneuver in predicting difficult laryngoscopy and intubation
Identifieur interne : 002588 ( Main/Exploration ); précédent : 002587; suivant : 002589Comparison of Mallampati test with lower jaw protrusion maneuver in predicting difficult laryngoscopy and intubation
Auteurs : Muhammad Irfan Ul Haq [Pakistan] ; Hameed Ullah [Pakistan]Source :
- Journal of Anaesthesiology, Clinical Pharmacology [ 0970-9185 ] ; 2013.
Abstract
Failure to maintain a patent airway is one of the commonest causes of anesthesia-related morbidity and mortality. Many protocols, algorithms, and different combinations of tested methods for airway assessment have been developed to predict difficult laryngoscopy and intubation. The reported incidence of a difficult intubation varies from 1.5% to 13%. The objective of this study was to compare Mallampati test (MT) with lower jaw protrusion (LJP) maneuver in predicting difficult laryngoscopy and intubation.
Seven hundred and sixty patients were included in the study. All the patients underwent MT and LJP maneuver for their airway assessment. After a standardized technique of induction of anesthesia, primary anesthetist performed laryngoscopy and graded it according to the grades described by Cormack and Lehane. Sensitivity, specificity, accuracy, and positive predictive value (PPV) and negative predictive value (NPV) were calculated for both these tests with 95% confidence interval (CI) using conventional laryngoscopy as gold standard. Area under curve was also calculated for both, MT and LJP maneuver. A
LJP maneuver had higher sensitivity (95.9% vs. 27.1%), NPV (98.7% vs. 82.0%), and accuracy (90.1% vs. 80.3%) when compared to MT in predicting difficult laryngoscopy and intubation. Both tests, however, had similar specificity and PPV. There was marked difference in the positive and negative likelihood ratio between LJP and MT. Similarly, the area under the curve favored LJP maneuver over MT.
The results of this study show that LJP maneuver is a better test to predict difficult laryngoscopy and tracheal intubation. We recommend the addition of this maneuver to the routine preoperative evaluation of airway.
Url:
DOI: 10.4103/0970-9185.117059
PubMed: 24106353
PubMed Central: 3788227
Affiliations:
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: 002F59
- to stream Pmc, to step Curation: 002F59
- to stream Pmc, to step Checkpoint: 001A89
- to stream Ncbi, to step Merge: 004A35
- to stream Ncbi, to step Curation: 004A35
- to stream Ncbi, to step Checkpoint: 004A35
- to stream Main, to step Merge: 002599
- to stream Main, to step Curation: 002588
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Comparison of Mallampati test with lower jaw protrusion maneuver in predicting difficult laryngoscopy and intubation</title><author><name sortKey="Ul Haq, Muhammad Irfan" sort="Ul Haq, Muhammad Irfan" uniqKey="Ul Haq M" first="Muhammad Irfan" last="Ul Haq">Muhammad Irfan Ul Haq</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Anesthesiology, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan</nlm:aff><country xml:lang="fr">Pakistan</country><wicri:regionArea>Department of Anesthesiology, Aga Khan University Hospital, Stadium Road, Karachi</wicri:regionArea><wicri:noRegion>Karachi</wicri:noRegion></affiliation></author><author><name sortKey="Ullah, Hameed" sort="Ullah, Hameed" uniqKey="Ullah H" first="Hameed" last="Ullah">Hameed Ullah</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Anesthesiology, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan</nlm:aff><country xml:lang="fr">Pakistan</country><wicri:regionArea>Department of Anesthesiology, Aga Khan University Hospital, Stadium Road, Karachi</wicri:regionArea><wicri:noRegion>Karachi</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24106353</idno><idno type="pmc">3788227</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3788227</idno><idno type="RBID">PMC:3788227</idno><idno type="doi">10.4103/0970-9185.117059</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">002F59</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002F59</idno><idno type="wicri:Area/Pmc/Curation">002F59</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002F59</idno><idno type="wicri:Area/Pmc/Checkpoint">001A89</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001A89</idno><idno type="wicri:Area/Ncbi/Merge">004A35</idno><idno type="wicri:Area/Ncbi/Curation">004A35</idno><idno type="wicri:Area/Ncbi/Checkpoint">004A35</idno><idno type="wicri:doubleKey">0970-9185:2013:Ul Haq M:comparison:of:mallampati</idno><idno type="wicri:Area/Main/Merge">002599</idno><idno type="wicri:Area/Main/Curation">002588</idno><idno type="wicri:Area/Main/Exploration">002588</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Comparison of Mallampati test with lower jaw protrusion maneuver in predicting difficult laryngoscopy and intubation</title><author><name sortKey="Ul Haq, Muhammad Irfan" sort="Ul Haq, Muhammad Irfan" uniqKey="Ul Haq M" first="Muhammad Irfan" last="Ul Haq">Muhammad Irfan Ul Haq</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Anesthesiology, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan</nlm:aff><country xml:lang="fr">Pakistan</country><wicri:regionArea>Department of Anesthesiology, Aga Khan University Hospital, Stadium Road, Karachi</wicri:regionArea><wicri:noRegion>Karachi</wicri:noRegion></affiliation></author><author><name sortKey="Ullah, Hameed" sort="Ullah, Hameed" uniqKey="Ullah H" first="Hameed" last="Ullah">Hameed Ullah</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Anesthesiology, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan</nlm:aff><country xml:lang="fr">Pakistan</country><wicri:regionArea>Department of Anesthesiology, Aga Khan University Hospital, Stadium Road, Karachi</wicri:regionArea><wicri:noRegion>Karachi</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of Anaesthesiology, Clinical Pharmacology</title><idno type="ISSN">0970-9185</idno><idno type="eISSN">2231-2730</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>Background:</title><p>Failure to maintain a patent airway is one of the commonest causes of anesthesia-related morbidity and mortality. Many protocols, algorithms, and different combinations of tested methods for airway assessment have been developed to predict difficult laryngoscopy and intubation. The reported incidence of a difficult intubation varies from 1.5% to 13%. The objective of this study was to compare Mallampati test (MT) with lower jaw protrusion (LJP) maneuver in predicting difficult laryngoscopy and intubation.</p></sec><sec id="st2"><title>Materials and Methods:</title><p>Seven hundred and sixty patients were included in the study. All the patients underwent MT and LJP maneuver for their airway assessment. After a standardized technique of induction of anesthesia, primary anesthetist performed laryngoscopy and graded it according to the grades described by Cormack and Lehane. Sensitivity, specificity, accuracy, and positive predictive value (PPV) and negative predictive value (NPV) were calculated for both these tests with 95% confidence interval (CI) using conventional laryngoscopy as gold standard. Area under curve was also calculated for both, MT and LJP maneuver. A <italic>P</italic> < 0.05 was taken as significant.</p></sec><sec id="st3"><title>Results:</title><p>LJP maneuver had higher sensitivity (95.9% vs. 27.1%), NPV (98.7% vs. 82.0%), and accuracy (90.1% vs. 80.3%) when compared to MT in predicting difficult laryngoscopy and intubation. Both tests, however, had similar specificity and PPV. There was marked difference in the positive and negative likelihood ratio between LJP and MT. Similarly, the area under the curve favored LJP maneuver over MT.</p></sec><sec id="st4"><title>Conclusion:</title><p>The results of this study show that LJP maneuver is a better test to predict difficult laryngoscopy and tracheal intubation. We recommend the addition of this maneuver to the routine preoperative evaluation of airway.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Gannon, K" uniqKey="Gannon K">K Gannon</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Domino, Kb" uniqKey="Domino K">KB Domino</name></author><author><name sortKey="Posner, Kl" uniqKey="Posner K">KL Posner</name></author><author><name sortKey="Caplan, Ra" uniqKey="Caplan R">RA Caplan</name></author><author><name sortKey="Cheney, Fw" uniqKey="Cheney F">FW Cheney</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cormack, Rd" uniqKey="Cormack R">RD Cormack</name></author><author><name sortKey="Lehane, J" uniqKey="Lehane J">J Lehane</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Utting, Je" uniqKey="Utting J">JE Utting</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gupta, S" uniqKey="Gupta S">S Gupta</name></author><author><name sortKey="Sharma, R" uniqKey="Sharma R">R Sharma</name></author><author><name sortKey="Jain, D" uniqKey="Jain D">D Jain</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Khan, Zh" uniqKey="Khan Z">ZH Khan</name></author><author><name sortKey="Kashifi, A" uniqKey="Kashifi A">A Kashifi</name></author><author><name sortKey="Ebrahimkhani, E" uniqKey="Ebrahimkhani E">E Ebrahimkhani</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hilditch, Wg" uniqKey="Hilditch W">WG Hilditch</name></author><author><name sortKey="Kopka, A" uniqKey="Kopka A">A Kopka</name></author><author><name sortKey="Crawford, Jm" uniqKey="Crawford J">JM Crawford</name></author><author><name sortKey="Asbury, Aj" uniqKey="Asbury A">AJ Asbury</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yentis, Sm" uniqKey="Yentis S">SM Yentis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Eberhart, Lh" uniqKey="Eberhart L">LH Eberhart</name></author><author><name sortKey="Arndt, C" uniqKey="Arndt C">C Arndt</name></author><author><name sortKey="Cierpka, T" uniqKey="Cierpka T">T Cierpka</name></author><author><name sortKey="Schwanekamp, J" uniqKey="Schwanekamp J">J Schwanekamp</name></author><author><name sortKey="Wolf, H" uniqKey="Wolf H">H Wolf</name></author><author><name sortKey="Putzke, C" uniqKey="Putzke C">C Putzke</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Munnur, U" uniqKey="Munnur U">U Munnur</name></author><author><name sortKey="De Boisblanc, B" uniqKey="De Boisblanc B">B de Boisblanc</name></author><author><name sortKey="Suresh, Ms" uniqKey="Suresh M">MS Suresh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Koh, Lk" uniqKey="Koh L">LK Koh</name></author><author><name sortKey="Kong, Cf" uniqKey="Kong C">CF Kong</name></author><author><name sortKey="Yam, Pc" uniqKey="Yam P">PC Yam</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bergler, W" uniqKey="Bergler W">W Bergler</name></author><author><name sortKey="Maleck, W" uniqKey="Maleck W">W Maleck</name></author><author><name sortKey="Baker Schreyer, A" uniqKey="Baker Schreyer A">A Baker-Schreyer</name></author><author><name sortKey="Ungemach, J" uniqKey="Ungemach J">J Ungemach</name></author><author><name sortKey="Petroianu, G" uniqKey="Petroianu G">G Petroianu</name></author><author><name sortKey="Hormann, K" uniqKey="Hormann K">K Hormann</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mallampati, Sr" uniqKey="Mallampati S">SR Mallampati</name></author><author><name sortKey="Gatt, Sp" uniqKey="Gatt S">SP Gatt</name></author><author><name sortKey="Gugino, Ld" uniqKey="Gugino L">LD Gugino</name></author><author><name sortKey="Waraksa, B" uniqKey="Waraksa B">B Waraksa</name></author><author><name sortKey="Freiburger, D" uniqKey="Freiburger D">D Freiburger</name></author><author><name sortKey="Liu, Pl" uniqKey="Liu P">PL Liu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Vani, V" uniqKey="Vani V">V Vani</name></author><author><name sortKey="Kamath, Sk" uniqKey="Kamath S">SK Kamath</name></author><author><name sortKey="Naik, Ld" uniqKey="Naik L">LD Naik</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Karkouti, K" uniqKey="Karkouti K">K Karkouti</name></author><author><name sortKey="Rose, Dk" uniqKey="Rose D">DK Rose</name></author><author><name sortKey="Ferris, Le" uniqKey="Ferris L">LE Ferris</name></author><author><name sortKey="Wigglesworth, Df" uniqKey="Wigglesworth D">DF Wigglesworth</name></author><author><name sortKey="Meisamai Fard, T" uniqKey="Meisamai Fard T">T Meisamai-Fard</name></author><author><name sortKey="Lee, H" uniqKey="Lee H">H Lee</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rosenstock, C" uniqKey="Rosenstock C">C Rosenstock</name></author><author><name sortKey="Gillesberg, I" uniqKey="Gillesberg I">I Gillesberg</name></author><author><name sortKey="Gatke, Mr" uniqKey="Gatke M">MR Gatke</name></author><author><name sortKey="Levin, D" uniqKey="Levin D">D Levin</name></author><author><name sortKey="Kristensen, Ms" uniqKey="Kristensen M">MS Kristensen</name></author><author><name sortKey="Rasmussen, Ls" uniqKey="Rasmussen L">LS Rasmussen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bevenour, Jj" uniqKey="Bevenour J">JJ Bevenour</name></author><author><name sortKey="Ludwig, Ta" uniqKey="Ludwig T">TA Ludwig</name></author><author><name sortKey="Benedict, P" uniqKey="Benedict P">P Benedict</name></author><author><name sortKey="Carmon, G" uniqKey="Carmon G">G Carmon</name></author><author><name sortKey="Tremper, Kk" uniqKey="Tremper K">KK Tremper</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sava, D" uniqKey="Sava D">D Sava</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kheterpal, S" uniqKey="Kheterpal S">S Kheterpal</name></author><author><name sortKey="Han, R" uniqKey="Han R">R Han</name></author><author><name sortKey="Tremper, Kk" uniqKey="Tremper K">KK Tremper</name></author><author><name sortKey="Shanks, A" uniqKey="Shanks A">A Shanks</name></author><author><name sortKey="Tait, Ar" uniqKey="Tait A">AR Tait</name></author><author><name sortKey="O Eilly, M" uniqKey="O Eilly M">M O’Reilly</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Defalque, Rj" uniqKey="Defalque R">RJ Defalque</name></author><author><name sortKey="Wright, Aj" uniqKey="Wright A">AJ Wright</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Siddiqui, R" uniqKey="Siddiqui R">R Siddiqui</name></author><author><name sortKey="Kazi, Wa" uniqKey="Kazi W">WA Kazi</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Pakistan</li></country></list><tree><country name="Pakistan"><noRegion><name sortKey="Ul Haq, Muhammad Irfan" sort="Ul Haq, Muhammad Irfan" uniqKey="Ul Haq M" first="Muhammad Irfan" last="Ul Haq">Muhammad Irfan Ul Haq</name></noRegion><name sortKey="Ullah, Hameed" sort="Ullah, Hameed" uniqKey="Ullah H" first="Hameed" last="Ullah">Hameed Ullah</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Santé/explor/EdenteV2/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 002588 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 002588 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Santé
|area= EdenteV2
|flux= Main
|étape= Exploration
|type= RBID
|clé= PMC:3788227
|texte= Comparison of Mallampati test with lower jaw protrusion maneuver in predicting difficult laryngoscopy and intubation
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:24106353" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a EdenteV2
| This area was generated with Dilib version V0.6.32. |  |