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Predicting the Difficult Airway: How Useful Are Preoperative Airway Tests?

  • Airway Management (LC Berkow, Section Editor)
  • Published:
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Abstract

Purpose of Review

Available bedside predictors continue to have limitations in recognizing all patients with difficult airways. This review article aims to summarize the published literature from 2015 until 2021 regarding these predictors.

Recent Findings

In addition to traditionally described and recently proposed predictors, increasingly, technology such as ultrasound seems to improve accuracy of pre-airway management assessments.

Summary

Current best practice advocates for a comprehensive airway examination to identify predictors for difficult bag-mask ventilation, supraglottic airway insertion, laryngoscopy and intubation, and front of neck access prior to airway instrumentation. This is crucial as the combination of the predictors improves the sensitivity and specificity in identifying the difficult airway. Adjunct tools such as ultrasound may be beneficial, especially in settings outside operating rooms where incidence of failed or difficult airway is higher. Predicted difficulty in any technique should prompt the airway expert to plan strategically prior to proceeding with airway instrumentation.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Acknowledgements

M. Parotto is the recipient of a Research Commendation Award from the Department of Anesthesiology and Pain Medicine, University of Toronto.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Canada

    Ya-Chu May Tsai & Matteo Parotto

  2. Department of Anesthesia and Pain Management, Toronto General Hospital, EN 429, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada

    Ya-Chu May Tsai & Matteo Parotto

  3. Department of Anesthesiology and Intensive Care, University Hospital San Luigi Gonzaga University of Turin, Turin, Italy

    Vincenzo Russotto

  4. Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada

    Matteo Parotto

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  1. Ya-Chu May Tsai
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Correspondence to Matteo Parotto.

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Tsai, YC.M., Russotto, V. & Parotto, M. Predicting the Difficult Airway: How Useful Are Preoperative Airway Tests?. Curr Anesthesiol Rep 12, 398–406 (2022). https://doi.org/10.1007/s40140-022-00525-1

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