Evaluation of the laryngoscopy view using the modified Cormack-Lehane scale during tracheal intubation in an intensive care unit. A prospective observational study
Copyright © 2019 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved..
BACKGROUND AND OBJECTVIES: Tracheal intubation in the Intensive Care Unit is associated with a high incidence of difficult intubation and complications. This may be due to a poor view of the glottis during direct laryngoscopy. The aim of this study is to determine if there is a relationship between laryngoscopy view using the modified Cormack-Lehane scale with the incidence of difficult intubation and complications.
METHODS: All patients who were subjected to tracheal intubated with direct laryngoscopy in the Intensive Care Unit over a 45 month period were included in the study. In all patients, an evaluation was made of the laryngoscopy view using the modified Cormack-Lehane scale, as well as the technical difficulty (number of intubations at first attempt, operator-reported difficulty, need for a Frova introducer), and the incidence of complications (hypotension, hypoxia, oesophageal intubation).
RESULTS: A total of 360 patients were included. When the grade of the modified Cormack-Lehane scale was increased from 1 to 4, the incidence of first success rate intubation decreased (1: 97%, 2a: 94%, 2b: 80%, 3: 60%, 4: 0%, p<.001), the incidence of moderate and severe difficulty intubation increased (1: 2%, 2a: 4%, 2b: 36%, 3: 77%, 4: 100%, p<.001.), as well as the need for a Frova guide (1: 7%, 2a: 8%, 2b: 45%, 3: 60%, 4: 100%, p<.001). When the grade of the modified Cormack-Lehane scale increased from 1 to 4, the incidence of hypoxia<90% increased (1: 20%, 2a: 20%, 2b: 28%, 3: 47%, 4: 100%, p=.0073), as well as hypoxia<80% (1: 11%, 2a: 10%, 2b: 12%, 3: 27%, 4: 100%, p=.00398). No relationship was observed between the incidence of hypotension and the grade of the modified Cormack-Lehane scale (p=ns).
CONCLUSIONS: During tracheal intubation in the Intensive Care Unit a close relationship was found between a poor laryngoscopy view using the modified Cormack-Lehane scale and a higher difficulty technique of intubation. A relationship was found between the incidence of hypoxia with a higher grade in the modified Cormack-Lehane scale. No relationship was found between hypotension and the modified Cormack-Lehane scale.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:66 |
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| Enthalten in: |
Revista espanola de anestesiologia y reanimacion - 66(2019), 5 vom: 09. Mai, Seite 250-258 |
| Sprache: |
Englisch |
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| Weiterer Titel: |
Evaluación de la escala modificada de Cormack-Lehane para visión laringoscópica durante la intubación orotraqueal en una unidad de cuidados críticos. Estudio prospectivo observacional |
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| Beteiligte Personen: |
Taboada, M [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 28.05.2020 Date Revised 27.05.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.redar.2019.01.004 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM29485665X |
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| 100 | 1 | |a Taboada, M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Evaluation of the laryngoscopy view using the modified Cormack-Lehane scale during tracheal intubation in an intensive care unit. A prospective observational study |
| 246 | 3 | 3 | |a Evaluación de la escala modificada de Cormack-Lehane para visión laringoscópica durante la intubación orotraqueal en una unidad de cuidados críticos. Estudio prospectivo observacional |
| 264 | 1 | |c 2019 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 28.05.2020 | ||
| 500 | |a Date Revised 27.05.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2019 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved. | ||
| 520 | |a BACKGROUND AND OBJECTVIES: Tracheal intubation in the Intensive Care Unit is associated with a high incidence of difficult intubation and complications. This may be due to a poor view of the glottis during direct laryngoscopy. The aim of this study is to determine if there is a relationship between laryngoscopy view using the modified Cormack-Lehane scale with the incidence of difficult intubation and complications | ||
| 520 | |a METHODS: All patients who were subjected to tracheal intubated with direct laryngoscopy in the Intensive Care Unit over a 45 month period were included in the study. In all patients, an evaluation was made of the laryngoscopy view using the modified Cormack-Lehane scale, as well as the technical difficulty (number of intubations at first attempt, operator-reported difficulty, need for a Frova introducer), and the incidence of complications (hypotension, hypoxia, oesophageal intubation) | ||
| 520 | |a RESULTS: A total of 360 patients were included. When the grade of the modified Cormack-Lehane scale was increased from 1 to 4, the incidence of first success rate intubation decreased (1: 97%, 2a: 94%, 2b: 80%, 3: 60%, 4: 0%, p<.001), the incidence of moderate and severe difficulty intubation increased (1: 2%, 2a: 4%, 2b: 36%, 3: 77%, 4: 100%, p<.001.), as well as the need for a Frova guide (1: 7%, 2a: 8%, 2b: 45%, 3: 60%, 4: 100%, p<.001). When the grade of the modified Cormack-Lehane scale increased from 1 to 4, the incidence of hypoxia<90% increased (1: 20%, 2a: 20%, 2b: 28%, 3: 47%, 4: 100%, p=.0073), as well as hypoxia<80% (1: 11%, 2a: 10%, 2b: 12%, 3: 27%, 4: 100%, p=.00398). No relationship was observed between the incidence of hypotension and the grade of the modified Cormack-Lehane scale (p=ns) | ||
| 520 | |a CONCLUSIONS: During tracheal intubation in the Intensive Care Unit a close relationship was found between a poor laryngoscopy view using the modified Cormack-Lehane scale and a higher difficulty technique of intubation. A relationship was found between the incidence of hypoxia with a higher grade in the modified Cormack-Lehane scale. No relationship was found between hypotension and the modified Cormack-Lehane scale | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Complicaciones | |
| 650 | 4 | |a Complications | |
| 650 | 4 | |a Critical care | |
| 650 | 4 | |a Cuidados críticos | |
| 650 | 4 | |a Hipotensión | |
| 650 | 4 | |a Hipoxia | |
| 650 | 4 | |a Hypotension | |
| 650 | 4 | |a Hypoxia | |
| 650 | 4 | |a Intensive Care Unit | |
| 650 | 4 | |a Intubación orotraqueal | |
| 650 | 4 | |a Orotracheal intubation | |
| 650 | 4 | |a Unidad de Cuidados Intensivos | |
| 700 | 1 | |a Soto-Jove, R |e verfasserin |4 aut | |
| 700 | 1 | |a Mirón, P |e verfasserin |4 aut | |
| 700 | 1 | |a Martínez, S |e verfasserin |4 aut | |
| 700 | 1 | |a Rey, R |e verfasserin |4 aut | |
| 700 | 1 | |a Ferreiroa, E |e verfasserin |4 aut | |
| 700 | 1 | |a Almeida, X |e verfasserin |4 aut | |
| 700 | 1 | |a Álvarez, J |e verfasserin |4 aut | |
| 700 | 1 | |a Baluja, A |e verfasserin |4 aut | |
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