Anatomical and Ultrasonographic Parameters to Predict Difficult Airway in Pediatrics

Study Overview
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Brief Summary
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This study was designed to assess the accuracy of ultrasonographic parameters in combination to clinical parameters in the prediction of difficult airway in pediatric population. All patients underwent a standard airway examination and sonographic airway assessment preoperatively and the predictive values for difficult airway of these methods were recorded.

Detailed Description
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Difficult airway in a pediatric patient is associated with more stresful situation than adults. Therefore, various clinical airways parameters have been investigated in the prediction of difficult airway. Sonographic evaluation to predict difficult airway is still primitive especially in pediatrics. Ultrasonography and clinical parameters have been shown to be used in predicting difficult airway, but there is no study showing which is a better predictor.

Official Title
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Evaluation of Anatomical and Ultrasonographic Parameters to Predict Difficult Airway in Pediatric Patients

Conditions
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Difficult Airway

Intervention / Treatment
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* Diagnostic Test: Ultrasonographic upper airway measurements


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Children, aged between 1-12 years Children who required endotracheal intubation under general anesthesia for elective procedures written informed parental consent Exclusion Criteria: children over the age of 12 restrictive neck movement tracheostomized patient previous laryngeal surgery leading deformation of the laryngeal anatomy

Ages Eligible for Study
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Minimum Age: 1 Year
Maximum Age: 12 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: Ultrasonographic upper airway measurements|Ultrasonographic upper airway measurements: Epiglottis-skin distance, Hyoid bone-skin distance, Anterior commissure-skin distance and Thickness of tounge|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cormack-Lehane Classification | he anesthesiologist, who is blind to the patient's preoperative airway evaluation and ultrasonographic airway measurements, performs intubation and evaluates the laryngeal view. | Three minutes after induction of anesthesia. | 
| Epiglottis skin distance in centimeters. | The anesthesiologist, who is blind to the patient's preoperative airway evaluation and is experienced user of ultrasonography, measures hyoid bone to skin distance. | Five minutes before induction of anesthesia. | 
| Hyoid bone-skin distance in centimeters. | The anesthesiologist, who is blind to the patient's preoperative airway evaluation and is experienced user of ultrasonography, measures hyoid bone to skin distance. | Five minutes before induction of anesthesia. | 
| Anterior commissure-skin distance in centimeters. | The anesthesiologist, who is blind to the patient's preoperative airway evaluation and is experienced user of ultrasonography, measures anterior commissure to skin distance. | Five minutes before induction of anesthesia | 
| Thickness of tongue root in centimeters | The anesthesiologist, who is blind to the patient's preoperative airway evaluation and is experienced user of ultrasonography, measures thickness of tongue root. | Five minutes before induction of anesthesia | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| intubation difficulty score (IDS )(between 0 to 7) | The anesthesiologist, who performed the intubation, evaluated the intubation difficulty. | During the intubation period | 
| Mallampati classification | Evaluated by the anesthesiologist who performs intubation. | The day before surgery | 
| Neck circumference in centimeters. | Evaluated by the anesthesiologist who performs intubation. | The day before surgery | 
| Sternomental distance in centimeters. | The distance between sternal notch and mentum. Evaluated by the anesthesiologist who performs intubation. | The day before surgery | 
| Thyromental distance in centimeters | The distance between thyroid notch and mentum. Evaluated by the anesthesiologist who performs intubation. | The day before surgery | 
| Body mass index (BMI) | Weight and height will be combined to report BMI in kg/m^2.Evaluated by the anesthesiologist who performs intubation. | The day before surgery | 
| intubation techniques | techniques consisting of classic laryngoscope, videolaryngoscope, stylet, and supraglottic airway device used in intubation | During the intubation period | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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difficult airway, pediatric anesthesia, laryngoscopy