Comparison of upper lip bite test and ratio of height to thyromental distance with other airway assessment tests for predicting difficult endotracheal intubation
Identifieur interne : 006493 ( Ncbi/Curation ); précédent : 006492; suivant : 006494Comparison of upper lip bite test and ratio of height to thyromental distance with other airway assessment tests for predicting difficult endotracheal intubation
Auteurs : Jigisha Prahladrai Badheka ; Pratik M. Doshi ; Ashutosh M. Vyas ; Nirav Jentilal Kacha ; Vandana S. ParmarSource :
- Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine [ 0972-5229 ] ; 2016.
Abstract
Various anatomical measurements and noninvasive clinical tests, singly or in various combinations can be performed to predict difficult intubation. Upper lip bite test (ULBT) and ratio of height to thyromental distance (RHTMD) are claimed to have high predictability. Hence, we have conducted this study to compare the predictive value of ULBT and RHTMD with the following parameters: Mallampati grading, inter-incisor gap, thyromental distance, sternomental distance, head and neck movements, and horizontal length of mandible for predicting difficult intubation.
In this single blinded, prospective, observational study involving 170 adult patients of either sex belonging to American Society of Anesthesiologists physical Status I–III scheduled to undergo general anesthesia were recruited. All patients were subjected to the preoperative airway assessment and, the above parameters were recorded correlated with Cormack and Lehane grade and analyzed. The number of intubation attempts and use of intubation aids were also noted.
ULBT and RHTMD had highest sensitivity (96.64%, 90.72%), specificity (82.35%, 80.39%), positive predictive value (92.74%, 91.53%), and negative predictive value (91.3%, 78.8%), respectively, compared to other parameters. While odds ratio and likelihood ratio >1 for all the tests.
ULBT can be used as a simple bedside screening test for prediction of difficult intubation, but it should be combined with other airway assessment tests for better airway predictability. RHTMD can also be used as an acceptable alternative.
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DOI: 10.4103/0972-5229.173678
PubMed: 26955210
PubMed Central: 4759991
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Comparison of upper lip bite test and ratio of height to thyromental distance with other airway assessment tests for predicting difficult endotracheal intubation</title><author><name sortKey="Badheka, Jigisha Prahladrai" sort="Badheka, Jigisha Prahladrai" uniqKey="Badheka J" first="Jigisha Prahladrai" last="Badheka">Jigisha Prahladrai Badheka</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Doshi, Pratik M" sort="Doshi, Pratik M" uniqKey="Doshi P" first="Pratik M." last="Doshi">Pratik M. Doshi</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Vyas, Ashutosh M" sort="Vyas, Ashutosh M" uniqKey="Vyas A" first="Ashutosh M." last="Vyas">Ashutosh M. Vyas</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Kacha, Nirav Jentilal" sort="Kacha, Nirav Jentilal" uniqKey="Kacha N" first="Nirav Jentilal" last="Kacha">Nirav Jentilal Kacha</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Parmar, Vandana S" sort="Parmar, Vandana S" uniqKey="Parmar V" first="Vandana S." last="Parmar">Vandana S. Parmar</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26955210</idno><idno type="pmc">4759991</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4759991</idno><idno type="RBID">PMC:4759991</idno><idno type="doi">10.4103/0972-5229.173678</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000641</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000641</idno><idno type="wicri:Area/Pmc/Curation">000641</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000641</idno><idno type="wicri:Area/Pmc/Checkpoint">000807</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000807</idno><idno type="wicri:Area/Ncbi/Merge">006493</idno><idno type="wicri:Area/Ncbi/Curation">006493</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Comparison of upper lip bite test and ratio of height to thyromental distance with other airway assessment tests for predicting difficult endotracheal intubation</title><author><name sortKey="Badheka, Jigisha Prahladrai" sort="Badheka, Jigisha Prahladrai" uniqKey="Badheka J" first="Jigisha Prahladrai" last="Badheka">Jigisha Prahladrai Badheka</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Doshi, Pratik M" sort="Doshi, Pratik M" uniqKey="Doshi P" first="Pratik M." last="Doshi">Pratik M. Doshi</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Vyas, Ashutosh M" sort="Vyas, Ashutosh M" uniqKey="Vyas A" first="Ashutosh M." last="Vyas">Ashutosh M. Vyas</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Kacha, Nirav Jentilal" sort="Kacha, Nirav Jentilal" uniqKey="Kacha N" first="Nirav Jentilal" last="Kacha">Nirav Jentilal Kacha</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author><author><name sortKey="Parmar, Vandana S" sort="Parmar, Vandana S" uniqKey="Parmar V" first="Vandana S." last="Parmar">Vandana S. Parmar</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation></author></analytic><series><title level="j">Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine</title><idno type="ISSN">0972-5229</idno><idno type="eISSN">1998-359X</idno><imprint><date when="2016">2016</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>Various anatomical measurements and noninvasive clinical tests, singly or in various combinations can be performed to predict difficult intubation. Upper lip bite test (ULBT) and ratio of height to thyromental distance (RHTMD) are claimed to have high predictability. Hence, we have conducted this study to compare the predictive value of ULBT and RHTMD with the following parameters: Mallampati grading, inter-incisor gap, thyromental distance, sternomental distance, head and neck movements, and horizontal length of mandible for predicting difficult intubation.</p></sec><sec id="st2"><title>Materials and Methods:</title><p>In this single blinded, prospective, observational study involving 170 adult patients of either sex belonging to American Society of Anesthesiologists physical Status I–III scheduled to undergo general anesthesia were recruited. All patients were subjected to the preoperative airway assessment and, the above parameters were recorded correlated with Cormack and Lehane grade and analyzed. The number of intubation attempts and use of intubation aids were also noted.</p></sec><sec id="st3"><title>Results:</title><p>ULBT and RHTMD had highest sensitivity (96.64%, 90.72%), specificity (82.35%, 80.39%), positive predictive value (92.74%, 91.53%), and negative predictive value (91.3%, 78.8%), respectively, compared to other parameters. While odds ratio and likelihood ratio >1 for all the tests.</p></sec><sec id="st4"><title>Conclusion:</title><p>ULBT can be used as a simple bedside screening test for prediction of difficult intubation, but it should be combined with other airway assessment tests for better airway predictability. 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