Ultrasound measurements for evaluation of changes in upper airway during anaesthesia induction and prediction difficult laryngoscopy: a prospective observational study
Abstract Upper airway collapsibility after anaesthesia induction may be associated with unpredictable difficult airway. However, most works on airway anatomy are tended to morphological description before anaesthesia. This study aimed to evaluate the changes of upper airway after anaesthesia inducti...
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| Format: | Article |
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Nature Portfolio
2022-11-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-21695-2 |
| _version_ | 1811328545124777984 |
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| author | Xia Wang Yong Wang Zhen-Wei Zheng Yu-Rui Liu Wu-Hua Ma |
| author_facet | Xia Wang Yong Wang Zhen-Wei Zheng Yu-Rui Liu Wu-Hua Ma |
| author_sort | Xia Wang |
| collection | DOAJ |
| description | Abstract Upper airway collapsibility after anaesthesia induction may be associated with unpredictable difficult airway. However, most works on airway anatomy are tended to morphological description before anaesthesia. This study aimed to evaluate the changes of upper airway after anaesthesia induction and using pre-anesthetic ultrasound measurements to predict Difficult Laryngoscopy (DL). We included 104 eligible subjects with complete data, who were performed tracheal intubations under general anaesthesia in the study. The upper airway changes before and after anaesthesia induction were determined by seven neck ultrasound measurements, included as follow: (1) Distance from skin to under surface of Tongue (DT), (2) Thickness of the thickest part of Tongue body (TT), (3) Hyoid Mental Distance (HMD), (4) Depth of Hyoid (DH), (5) Width of Hyoid (WH), (6) Distance from Skin to Epiglottis (DSE), (7) Depth of the anterior combination of the Vocal Cords (DVC). DL was evaluated with Cormack–Lehane (CL). Data regarding HMD [from 45.3 (42.4–48.5) to 41.1 (38.5–44.9) mm], DH [from 8.7 (6.6–10.9) to 7.0 (5.3–9.1) mm], DSE [from 20.1 (16.6–22.5) to 19.5 (16.5–21.6) mm] and the DVC [from 7.1 (5.7–8.3) to 6.8 (5.7–7.9) mm] were decreased (P < 0.05), while the DT [from 15.9 (13.1–18.4) to 17.4 (14.5–19.8) mm] was increased (P > 0.05) after anaesthesia induction. Additionally, when cut-off value of DSE was 21.25 mm before anaesthesia, it may be better predicted to DL [sensitivity 80.0% (95% CI: 60.7–91.6%) and specificity 83.8% (95% CI: 73.0–91.0%)]. The upper airway after induction showed the propensity of collapsibility by ultrasound measurements. Compared with other indicators, the DSE assessed by ultrasound might be considered to a valuable predictor of DL. Trial registration: The study was registered in ClinicalTrials.gov on 23th Jan 2019, ChiCTR1900021123. |
| first_indexed | 2024-04-13T15:27:04Z |
| format | Article |
| id | doaj.art-a8bf36863ac64bcfaee1b5b7375bacc0 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
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| spelling | doaj.art-a8bf36863ac64bcfaee1b5b7375bacc02022-12-22T02:41:29ZengNature PortfolioScientific Reports2045-23222022-11-0112111010.1038/s41598-022-21695-2Ultrasound measurements for evaluation of changes in upper airway during anaesthesia induction and prediction difficult laryngoscopy: a prospective observational studyXia Wang0Yong Wang1Zhen-Wei Zheng2Yu-Rui Liu3Wu-Hua Ma4First Clinical Medical College, Guangzhou University of Chinese MedicineDepartment of Anaesthesia, The First Affiliated Hospital of Guangzhou University of Chinese MedicineDepartment of Anaesthesiology, Second Affiliated Hospital of Shantou University Medical CollegeFirst Clinical Medical College, Guangzhou University of Chinese MedicineDepartment of Anaesthesia, The First Affiliated Hospital of Guangzhou University of Chinese MedicineAbstract Upper airway collapsibility after anaesthesia induction may be associated with unpredictable difficult airway. However, most works on airway anatomy are tended to morphological description before anaesthesia. This study aimed to evaluate the changes of upper airway after anaesthesia induction and using pre-anesthetic ultrasound measurements to predict Difficult Laryngoscopy (DL). We included 104 eligible subjects with complete data, who were performed tracheal intubations under general anaesthesia in the study. The upper airway changes before and after anaesthesia induction were determined by seven neck ultrasound measurements, included as follow: (1) Distance from skin to under surface of Tongue (DT), (2) Thickness of the thickest part of Tongue body (TT), (3) Hyoid Mental Distance (HMD), (4) Depth of Hyoid (DH), (5) Width of Hyoid (WH), (6) Distance from Skin to Epiglottis (DSE), (7) Depth of the anterior combination of the Vocal Cords (DVC). DL was evaluated with Cormack–Lehane (CL). Data regarding HMD [from 45.3 (42.4–48.5) to 41.1 (38.5–44.9) mm], DH [from 8.7 (6.6–10.9) to 7.0 (5.3–9.1) mm], DSE [from 20.1 (16.6–22.5) to 19.5 (16.5–21.6) mm] and the DVC [from 7.1 (5.7–8.3) to 6.8 (5.7–7.9) mm] were decreased (P < 0.05), while the DT [from 15.9 (13.1–18.4) to 17.4 (14.5–19.8) mm] was increased (P > 0.05) after anaesthesia induction. Additionally, when cut-off value of DSE was 21.25 mm before anaesthesia, it may be better predicted to DL [sensitivity 80.0% (95% CI: 60.7–91.6%) and specificity 83.8% (95% CI: 73.0–91.0%)]. The upper airway after induction showed the propensity of collapsibility by ultrasound measurements. Compared with other indicators, the DSE assessed by ultrasound might be considered to a valuable predictor of DL. Trial registration: The study was registered in ClinicalTrials.gov on 23th Jan 2019, ChiCTR1900021123.https://doi.org/10.1038/s41598-022-21695-2 |
| spellingShingle | Xia Wang Yong Wang Zhen-Wei Zheng Yu-Rui Liu Wu-Hua Ma Ultrasound measurements for evaluation of changes in upper airway during anaesthesia induction and prediction difficult laryngoscopy: a prospective observational study Scientific Reports |
| title | Ultrasound measurements for evaluation of changes in upper airway during anaesthesia induction and prediction difficult laryngoscopy: a prospective observational study |
| title_full | Ultrasound measurements for evaluation of changes in upper airway during anaesthesia induction and prediction difficult laryngoscopy: a prospective observational study |
| title_fullStr | Ultrasound measurements for evaluation of changes in upper airway during anaesthesia induction and prediction difficult laryngoscopy: a prospective observational study |
| title_full_unstemmed | Ultrasound measurements for evaluation of changes in upper airway during anaesthesia induction and prediction difficult laryngoscopy: a prospective observational study |
| title_short | Ultrasound measurements for evaluation of changes in upper airway during anaesthesia induction and prediction difficult laryngoscopy: a prospective observational study |
| title_sort | ultrasound measurements for evaluation of changes in upper airway during anaesthesia induction and prediction difficult laryngoscopy a prospective observational study |
| url | https://doi.org/10.1038/s41598-022-21695-2 |
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