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Prediction of difficult laryngoscopy using spirometry: a pilot study

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Abstract

Prediction of difficult laryngoscopy is still the uncovered secret of anesthetic practice. This pilot study is aimed to assess the efficacy of spirometry measurements in predicting difficult laryngoscopy compared with conventional airway assessment techniques. We enrolled 202 adults, ages 18–40 years, with an American Society of Anaesthesiologists score of I or II, scheduled for elective surgery and undergoing general anesthesia. Spirometry was used for lung capacity measurements before the operation. The Mallampati classification, neck circumference, sternomental distance, thyromental distance, maximum mouth-opening measurement, and upper lip bite test of the subjects were measured. During intubation, the Cormack–Lehane grade was recorded. Spearman’s correlation analysis was used to define the linearity between spirometry outputs and airway measurements. Receiver operating curves were drawn to discriminate the predictive features of the significant values. The thyromental distance showed a higher correlation with forced inspiratory vital capacity (ρ = 0.420, P < 0.001). In a multivariate linear regression model, all spirometry measurements revealed that forced inspiratory vital capacity (β = −2.050, P = 0.022) was the significant predictor for difficult laryngoscopy. The area under the curve for forced inspiratory vital capacity with a cut-off value of 3.1950 L while using thyromental distance as difficult laryngoscopy indicator is 0.754 and forced inspiratory vital capacity showed a sensitivity of 0.718 and specificity of 0.714 with a positive likelihood ratio of 2.5104 and negative likelihood ratio of 0.3949. Forced inspiratory vital capacity showed a close association with the prediction of difficult laryngoscopy.

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Acknowledgements

We would like to thank H. Astan, H. Kanadli, A. Karakis, and F. Uzunkaya for their help in this study.

Authors’ contribution

S. Dogru, Literature search, data collection, study design, analysis of data, manuscript preparation; T. Karaman, Literature search, data collection, review the article; A. Sahin, H. Tapar, S. Karaman, S. Arici, M. Suren, Z. Kaya and B. T. Somuk, Literature search, data collection.

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Authors and Affiliations

  1. Department of Anesthesiology and Reanimation, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey

    Serkan Dogru, Tugba Karaman, Aynur Sahin, Hakan Tapar, Serkan Karaman, Semih Arici, Mustafa Suren & Ziya Kaya

  2. Department of Otorhinolaryngology, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey

    Battal Tahsin Somuk

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  1. Serkan Dogru
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  2. Tugba Karaman
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Correspondence to Serkan Dogru.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration.

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Informed consent was obtained from all individual participants included in the study.

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Dogru, S., Karaman, T., Sahin, A. et al. Prediction of difficult laryngoscopy using spirometry: a pilot study. J Clin Monit Comput 31, 1115–1121 (2017). https://doi.org/10.1007/s10877-016-9961-2

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  • DOI: https://doi.org/10.1007/s10877-016-9961-2

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