The morphometric approach in the predictive diagnosis of the anatomically difficult airway

Abstract

Introduction: The main objective in the clinical assessment of the airway is to identify predictive factors leading to failed or traumatic intubations, to surgical procedures cancellation and to patient exposure to hypoxia, brain damage or death.
Objective: To carry out an updating about the airway predictive status, as well as to propose an integrated predictive model as an identifier of the degree of difficulty for tracheal intubation of the surgical adult.
Development: specific findings of the airway physical exploration were incorporated into numerous assessment systems with the aim at predicting an anatomically difficult airway. The existing evaluation systems for predicting the degree of difficulty in trachea intubation have shown low specificity and sensitivity. With the combination of assessment systems, we identified increased diagnostic sensitivity and specificity, in addition to high positive and negative predictive value.
Conclusions: the anatomically difficult airway should be diagnosed early in order to predict how difficult it could be and unnecessarily avoid this emergency. Including the morphometric approach, as a model of morphological clinical integration in the preoperative assessment of the surgical patient, makes the timely detection of an anatomically difficult airway and its control more suitable. They should be included in routine assessments of respiratory access and in the preanesthetic assessment of each patient.