Identification of Morphological Characteristics to Predict Difficult Endotracheal Intubation Using a Flexible Fiberscope
- Conditions
- Intubation; Difficult
- Interventions
- Device: Flexible fiberscope
- Registration Number
- NCT02769819
- Lead Sponsor
- Centre hospitalier de l'Université de Montréal (CHUM)
- Brief Summary
This study is designed to identify patients' features predictive of difficult endotracheal intubation using a flexible fiberscope.
- Detailed Description
Endotracheal intubation is an important act in the practice of anesthesiology. Direct laryngoscopy is the most commonly used technique to accomplish this task. Airway characteristics predicting difficult intubation with direct laryngoscopy are well defined. Physical findings, such as Mallampati classification or measurements of the thyromental distance, mouth opening, and neck extension have been validated to help anticipate difficult situations with the direct laryngoscope. When direct laryngoscopy is difficult, early conversion to an alternative technique reduces the risk of airway compromise and associated morbidity.
Many alternative intubation devices are now available, and part of the anesthesiologist's task is to select the alternative approach best suited to each patient's specific features. Despite its use for both elective and unexpectedly difficult intubation, predictive criteria for successful airway management with the flexible fiberscope have not been developed.
The purpose of this study is to identify patient morphometric or morphological characteristics, if any, that could predict difficult intubation when using the flexible fiberscope for perioperative tracheal intubation in an elective surgical population.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 420
- Age 18 and older
- Patients undergoing elective surgery under general anesthesia, requiring endotracheal intubation
- Induction planned without neuromuscular blocking agents
- Need for a rapid sequence induction
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Intubation with a flexible fiberscope Flexible fiberscope Following induction of general anesthesia and administration of a neuromuscular blocking agent, intubation will be performed using a flexible fiberscope.
- Primary Outcome Measures
Name Time Method Morphologic and morphometric predictors of difficult intubation with the flexible fiberscope. Patients will be followed from induction of anesthesia until the end of intubation, an average of 10 minutes This study will correlate patients' morphometric and morphologic characteristics with the number of attempts and time needed for intubation using a flexible fiberscope.
- Secondary Outcome Measures
Name Time Method Time to successful intubation Patients will be followed from induction of anesthesia until the end of intubation, an average of 10 minutes Number of attempts to successful intubation Patients will be followed from induction of anesthesia until the end of intubation, an average of 10 minutes Score on the Intubation Difficulty Scale Patients will be followed from induction of anesthesia until the end of intubation, an average of 10 minutes To calculate the Intubation Difficulty Scale the following variables will be collected: number of attempts, number of operators, necessity to use an alternative intubation technique, glottic visualization and effort needed to obtain optimal view of the glottis, necessity of external laryngeal pressure and vocal cords position during intubation.
Trial Locations
- Locations (1)
Centre Hospitalier de l'Université de Montréal (CHUM)
🇨🇦Montreal, Quebec, Canada