Clinical trial NCT02769819: Identification of Morphological Characteristics to Predict Difficult Endotracheal Intubation Using a Flexible Fiberscope
Official title: Identification of Morphological Characteristics to Predict Difficult Endotracheal Intubation Using a Flexible Fiberscope
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Intubation; Difficult
Keywords: Flexible fiberscope
Lead sponsor: Centre hospitalier de l'Université de Montréal (CHUM)
Sponsor class: OTHER
First posted: 2016-05-12
Enrollment: 420
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: OTHER

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.

Eligibility criteria: Inclusion Criteria:

* Age 18 and older
* Patients undergoing elective surgery under general anesthesia, requiring endotracheal intubation

Exclusion Criteria:

* Induction planned without neuromuscular blocking agents
* Need for a rapid sequence induction

Primary outcomes:
measure: Morphologic and morphometric predictors of difficult intubation with the flexible fiberscope.
timeFrame: Patients will be followed from induction of anesthesia until the end of intubation, an average of 10 minutes
Secondary outcomes:
measure: Time to successful intubation
timeFrame: Patients will be followed from induction of anesthesia until the end of intubation, an average of 10 minutes
measure: Number of attempts to successful intubation
timeFrame: Patients will be followed from induction of anesthesia until the end of intubation, an average of 10 minutes
measure: Score on the Intubation Difficulty Scale
timeFrame: Patients will be followed from induction of anesthesia until the end of intubation, an average of 10 minutes
Other outcomes:
Locations:
city: Montreal
country: Canada
facility: Centre Hospitalier de l'Université de Montréal (CHUM)
state: Quebec
Study officials:
affiliation: Centre hospitalier de l'Université de Montréal (CHUM)
name: Stephan R Williams, MD, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Toure T, Williams SR, Kerouch M, Ruel M. Patient factors associated with difficult flexible bronchoscopic intubation under general anesthesia: a prospective observational study. Can J Anaesth. 2020 Jun;67(6):706-714. doi: 10.1007/s12630-020-01568-w. Epub 2020 Jan 17.