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Dergiler / Haseki Tıp Bülteni / 2019 / Cilt: 57 - Sayı: 1

Difficult Mask Ventilation in Obese Patients: New Predictive Tests?

Obez Hastalarda Zor Maske Ventilasyonu: Yeni Prediktif Testler?

BENGÜ GÜLHAN AYDIN
GAMZE KÜÇÜKOSMAN
ÖZCAN PİŞKİN
RAHŞAN DİLEK OKYAY
HİLAL AYOĞLU
Sayfa
15–19
DOI
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Tests and measurements at the bedside are not sufficient alone and we believe that they will be more reliable when considered together.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:Aim: The aim of our study was to evaluate specific factors in predicting difficult mask ventilation (DMV) in obese patients undergoing elective surgery.
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Temel Bulgular & Veri:Methods: This prospective and observational study was performed in 90 obese patients.
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Sonuç & Katkı:Tests and measurements at the bedside are not sufficient alone and we believe that they will be more reliable when considered together.
🔬Tür:Araştırma Makalesi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alan Parametreleri

Özet

Aim: The aim of our study was to evaluate specific factors in predicting difficult mask ventilation (DMV) in obese patients undergoing elective surgery. Methods: This prospective and observational study was performed in 90 obese patients. We assessed age, height, weight, sex, body mass index (BMI), dental structure, presence of facial hair, modified Mallampati test result, mouth opening, thyromental distance (TMD), sternomental distance, mandibular protrusion, mandibular length, neck circumference (NC), neck length, upper lip bite test result, height to TMD ratio, NC to TMD ratio (NC/TMD), and history of snoring and Obstructive Sleep Apnea syndrome for estimation of DMV. Results: The mean age of the patients was 40.9±9.4 years and the mean BMI was 44.7±6.2 kg/m2 . Of all patients 38.9% were determined to have DMV. Clinical variables associated with DMV were male gender, mandibular length, snoring, NC, and NC/TMD. Multiple logistic regression analysis showed that male gender (p=0.047) and snoring (p=0.02) were independent factors. Conclusion: We believe that NC/TMD and ML are predictive tests for DMV in obese patients. Tests and measurements at the bedside are not sufficient alone and we believe that they will be more reliable when considered together.

Abstract

Amaç: Çalışmamızın amacı elektif cerrahi uygulanan obez hastalarda maske ventilasyonunun zorluğunun belirlenmesinde spesifik faktörlerin etkisini değerlendirmektir. Yöntemler: Bu prospektif ve gözlemsel planlanan çalışmaya 90 hasta dahil edildi. Zor maske ventilasyonu (ZMV) tahmininde yaş, boy, kilo, cinsiyet, vücut kitle indeksi (VKİ), diş yapısı, sakal varlığı, modifiye mallampati testi, ağız açıklığı, tiromental mesafe (TM), sternomental mesafe, mandibula protrüzyonu, mandibula uzunluğu (MU), boyun çevresi (BÇ), boyun uzunluğu, üst dudak ısırma testi, boyun çevresi/ tiromental mesafe (BÇ/TM) oranı, horlama ve obstrüktif sleep apne sendromu varlığının etkisini değerlendirdik. Bulgular: Ortalama yaş ve VKİ sırasıyla 40,9±9,4 yıl ve 44,7±6,2 kg/ m2 idi. Olguların %38,9’unun ZMV olduğu belirlendi. ZMV ile ilişkili klinik değişkenler erkek yaş, MU, horlama, BÇ ve BÇ/TM oranı idi. Çoklu regresyon analizi, erkek cinsiyetin (p=0,047) ve horlamanın (p=0,02) bağımsız faktörler olduğunu ortaya koymuştur. Sonuç: Obez hastalarda BÇ/TM ve MU’nun ZMV için prediktif testler olduğunu düşünüyoruz. Yatak başı yapılan testler ve ölçümlerin tek başına yeterli olmadığını, birlikte değerlendirildiğinde daha güvenilir olacağına inanıyoruz.

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Bu Makaleye Atıf Yap

AYDIN, B. G., KÜÇÜKOSMAN, G., PİŞKİN, Ö., OKYAY, R. D., AYOĞLU, H. (2019). Difficult Mask Ventilation in Obese Patients: New Predictive Tests?. Haseki Tıp Bülteni, Cilt: 57 - Sayı: 1, 15–19. https://ajindex.com/articles/190399

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Kaynakça (13)

  1. Parameswaran K, Todd DC. Soth M. Altered respiratory physiology in obesity. Can Respir J 2006;13:203-10. World Health Organization Unhealhty Diets and Physical İnactivity Fact Sheet June 2009. http://www.Who.int/nmh/ publications/fact_sheet_diet_en.pdf. Pedoto A. Lung physiology and obesity: Anesthetic Implication for Thoracic Procedures Anesthesiol Res Pract 2012;2012:154208. Cook TM, Woodall N, Frerk C. Fourth National Audit Project. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br J Anaesth 2011;106:617-31.
  2. Arens R, Sin S, Nandalike K, Rieder J, et al. Upper airway structure and body fat composition in obese children with obstructive sleep apnea syndrome. Am J Respir Crit Care Med 2011;183:782-7.
  3. Pelosi P, Croci M, Ravagnan I, et al. Total respiratory system, lung, and chest Wall mechanics in sedated-paralyzed postoperative morbidly obese patients. Chest 1996;109:144-51.
  4. Juvin P, Lavaut E, Dupont H, et al. Difficult tracheal intubation is more common in obese than in lean patients. Anesth Analg 2003;97:595-600.
  5. Langeron O, Birenbaum A, Le Saché F, et al. Airway management in obese patient. Minerva Anestesiol 2014;80:382-92.
  6. Langeron O, Masso E, Huraux C, et al. Prediction of difficult mask ventilation. Anesthesiology 2000;92:1229-36.
  7. Yildiz TS, Solak M, Toker K. The incidence and risk factors of difficult mask ventilation. J Anesth 2005;19:7-11.
  8. Binks A, Pyke M. Anaesthesia for the obese patient. Anaesthesia & Intensive Care Medicine 2008;9:299-302.
  9. Han R, Tremper KK, Kheterpal S, et al. Grading scale for mask ventilation. Anesthesiology 2004;101:267. Noble DW, Mccallum F. Anaesthesia for the obese patient. Anaesthesia & Intensive Care Medicine 2004;5:92-95.
  10. Apfelbaum JL, Hagberg CA, Caplan RA, et al; American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology 2013;118:251-70.
  11. Kheterpal S, Han R, Tremper KK, et al. Incidence and predictors of difficult and impossible mask ventilation. Anesthesiology 2006;105:885-91.
  12. Williamson JA, Webb RK, Szekely S, et al. Difficult intubation: an analysis of 2000 incident reports. Anaesth Intens Care 1993;21:602-7.
  13. Leoni A, Arlati S, Ghisi D, et al. Difficult mask