Patients with difficult intubation may need referral to sleep clinics

Anesthesia and Analgesia
Frances ChungColin M Shapiro

Abstract

Upper airway abnormalities carry the risk of obstructive sleep apnea (OSA) and difficult tracheal intubations. Both conditions contribute to significant clinical problems and have increased perioperative morbidity and mortality. We hypothesized that patients who presented with difficult intubation would have a very high prevalence of OSA and that those with unexpected difficult intubation may require referral to sleep clinics for polysomnography (PSG). Patients classified as a grade 4 Cormack and Lehane on direct laryngoscopic view, and who required more than two attempts for successful endotracheal intubation, were referred to the study by consultant anesthesiologists at four hospitals. Apnea-hypopnea index (AHI) data and postoperative events were collected. Patients with AHI >5/h were considered positive for OSA. Clinical and PSG variables were compared using t-tests and chi(2) test. Over a 20-mo period, 84 patients with a difficult intubation were referred into the study. Thirty-three patients agreed to participate. Sixty-six percent (22 of 33) had OSA (AHI >5/h). Of the 22 OSA patients, 10 patients (64%) had mild OSA (AHI 5-15), 6 (18%) had moderate OSA (AHI >15/h), and 6 (18%) had severe OSA (AHI >30/h). Of the 33 patients...Continue Reading

Associated Clinical Trials

Jun 13, 2016·Dr. Frances Chung

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Citations

Jan 18, 2011·Sleep & Breathing = Schlaf & Atmung·Chun Ling WangJin Min
Jul 20, 2011·Current Treatment Options in Neurology·Roop KawNancy A Collop
Aug 5, 2010·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Edwin Seet, Frances Chung
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May 22, 2010·Anesthesiology Clinics·Edwin Seet, Frances Chung
Oct 6, 2016·The Journal of Hand Surgery·Michael P GasparA Lee Osterman
Dec 3, 2014·Critical Care Nursing Quarterly·Penelope Z Strauss
May 17, 2012·Journal of Intensive Care Medicine·Jahan PorhomayonAli A El-Solh
Mar 23, 2011·Anesthesiology·Frances ChungRalph Lydic
Jan 5, 2018·European Journal of Anaesthesiology·Martin Roesslein, Frances Chung
Nov 18, 2010·Anesthesia and Analgesia·Stavros MemtsoudisMadhu Mazumdar
Nov 26, 2015·Anesthesia and Analgesia·Eric DeflandreVincent Bonhomme
May 5, 2009·Current Opinion in Anaesthesiology·Frances Chung, Hisham Elsaid
Dec 19, 2016·Respirology : Official Journal of the Asian Pacific Society of Respirology·David R Hillman, Frances Chung
Apr 16, 2021·Anesthesia and Analgesia·Edwin SeetDavid T Wong
May 7, 2009·Current Opinion in Anaesthesiology
Jan 2, 2018·Journal of Clinical Anesthesia·Siaw May LeongDavid T Wong

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