Development and validation of a screening method for difficult tracheal intubation based on geometric simulation and computer technology

BMC Anesthesiology

Research

Xiaogan Jiang¹  Bin Wang²  Mingfang Wang²  Pingping Cheng²  Jingjing Cao²  Zhiyuan Dong²  Jianling Xu²  Yue Yu²  Xinyuan Tang²  Weidong Yao³  Yue Wu⁴ 

[1] Anhui Province Clinical Research Center for Critical Care Medicine (Respiratory Disease), Wannan Medical College, Wuhu, Anhui, China;Department of Anesthesiology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China;Department of Anesthesiology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China;Anhui Province Clinical Research Center for Critical Care Medicine (Respiratory Disease), Wannan Medical College, Wuhu, Anhui, China;Department of Anesthesiology, The First People’s Hospital of Wuhu City, Wuhu, Anhui, China;

关键词: Difficult airway;    Prediction;    Geometry;    Airway management;    Computer;   

DOI  :  10.1186/s12871-023-02312-9

 received in 2023-03-19, accepted in 2023-10-16,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe anatomical characteristics of difficult airways can be analysed geometrically. This study aims to develop and validate a geometry-assisted difficult airway screening method (GADAS method) for difficult tracheal intubation.MethodsIn the GADAS method, a geometric simulated model was established based on computer graphics. According to the law of deformation of the upper airway on laryngoscopy, the expected visibility of the glottis was calculated to simulate the real visibility on laryngoscopy. Validation of the new method: Approved by the Ethics Committee of Yijishan Hospital of Wannan Medical College. Adult patients who needed tracheal intubation under general anaesthesia for elective surgery were enrolled. The data of patients were input into the computer software to calculate the expected visibility of the glottis. The results of tracheal intubation were recorded by anaesthesiologists. The primary observation outcome was the screening performance of the expected visibility of the glottis for difficult tracheal intubation.ResultsThe geometric model and software of the GADAS method were successfully developed and are available for use. We successfully observed 2068 patients, of whom 56 patients had difficult intubation. The area under the receiver operating characteristic curve of low expected glottis visibility for predicting difficult laryngoscopy was 0.96 (95% confidence interval [CI]: 0.95–0.96). The sensitivity and specificity were 89.3% (95% CI: 78.1-96.0%) and 94.3% (95% CI: 93.2%-95.3), respectively.ConclusionsIt is feasible to screen difficult-airway patients by applying computer techniques to simulate geometric changes in the upper airway.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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