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The Relationship of Anthropometric Indices and Hemodynamic Changes After Laryngoscopy



Safavi M1 ; Honarmand A1 ; Kashefi P1 ; Attari M1 ; Heidari M1 ; Habibzadeh M2 ; Nazem M3 ; Mohammadsharifi G4 ; Ghorbani E4 ; Galali H5
Authors
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Authors Affiliations
  1. 1. Department of Anesthesiology and Critical Care, School of Medicine AND Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Fellow of Intensive Care Unit (ICU), Imam Hossein Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Isfahan University of Medical Sciences, Isfahan, Iran

Source: Journal of Isfahan Medical School Published:2014

Abstract

Background: Laryngoscopy and endotracheal intubation are critical procedures and if the anthropometric indices of the patient leading to difficult intubation are not considered before the procedure, it can be accompanied by serious complications. One of the most practical concepts suggested about difficult intubation, is Cormack and Lehane criteria used in most medical centers. However, there is not any valuable study demonstrate the effect of anthropometric indices in difficult intubation and the immediate prediction of its complications. This study aimed to evaluate the correlation of anthropometric indices and hemodynamic changes after laryngoscopy and endotracheal intubation. Methods: This descriptive-analytic study was carried out in 2012 in Kashani hospital, Isfahan, Iran. 130 patients with fulfilling inclusion criteria were entered the study. The recorded data included age, weight, height, neck circumference, waist-to-hip ratio and body mass index. The difficulty of intubation was assessed when the patient was completely unconscious. The predictive role of obesity indices in difficult intubation and the cardiovascular changes after intubation was assessed using receiver operating characteristic (ROC) curve. Findings: The best cut-off point for body mass index (BMI) was 26.56; according to this cut-off point, the sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of BMI were 100, 38.84, 10.8 and 91.1 percent, respectively. The best cut-off point for neck circumference was 38; according to this cut-off point, the sensitivity, specificity, PPV and NPV of neck circumference were 7.85, 2.28, 2.45, 1.91 percent, respectively. Conclusion: BMI, neck circumference and waist-to-hip ratio are valuable in assessing difficult intubation and their value is mostly due to NPV. Therefore, we can achieve a significant NPV and sensitivity in assessment of difficult intubation by considering all these indices.
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