miércoles, 7 de diciembre de 2016

Vía aérea / Airway

Diciembre 7,  2016. No. 2531






Clasificación Cormack-Lehane revisada
Cormack-Lehane classification revisited.
Br J Anaesth. 2010 Aug;105(2):220-7. doi: 10.1093/bja/aeq136. Epub 2010 Jun 16.
Abstract
BACKGROUND: The Cormack-Lehane (CL) classification is broadly used to describe laryngeal view during direct laryngoscopy. This classification, however, has been validated by only a few studies reporting inconclusive data concerning its reliability. This discrepancy between widespread use and limited evidence prompted us to investigate the knowledge about the classification among anaesthesiologists and its intra- and inter-observer reliability. METHODS: One hundred and twenty interviews were performed at a major European anaesthesia congress. Participants were interviewed about their general knowledge on grading systems to classify laryngeal view during laryngoscopy and were subsequently asked to define the grades of the CL classification. Inter- and intra-observer reliabilities were tested in 20 anaesthesiologists well familiar with the CL classification, who performed 100 laryngoscopies in a full-scale patient simulator. RESULTS: Although 89% of interviewed subjects claimed to know a classification to describe laryngeal view during laryngoscopy, 53% were able to name a classification. When specifically asked about the CL classification, 74% of the interviewed subjects stated to know this classification, whereas 25% could define all four grades correctly. In the simulator-based part of the study, inter-observer reliability was fair with a kappa coefficient of 0.35 and intra-observer reliability was poor with a kappa of 0.15. CONCLUSIONS: The CL classification is poorly known in detail among anaesthesiologists and reproducibility even in subjects well familiar with this classification is limited.
Clasificación de Mallampati modificada en la determinación del éxito de ecocardiografía transesofágica en pacientes no sedados con cardiopatía: simple pero eficiente
Modified mallampati classification in determining the success of unsedated transesophageal echocardiography procedure in patients with heart disease: simple but efficient.
Cardiovasc Ultrasound. 2016 Oct 5;14(1):42.
Abstract
BACKGROUND: The transesophageal echocardiograhpy (TEE) has been studied worldwide. However, identifying additional factors on top of operator's experience and patient's cooperation which could influence the success of the procedure in unsedated patients with heart disease  is not well documented. METHODS: Under the cross-sectional descriptive design, 85 target patients were fulfilling the criteria: being Thai national at the age of at least 20-year-old, being performed TEE by the study participant's cardiologists, being able to communicate verbally. Seven outcomes were recorded, including gag reflex, insertion attempt, insertion time, vital signs (heart rate, oxygen saturation and mean arterial blood pressure), visible blood on TEE probe tip, and oropharyngeal pain at 1 h and 24-h.  CONCLUSIONS: Modified Mallampati Classification is one of determining factors in the success of unsedated TEE procedure in patients with heart disease, especially for assessment of gagging and successful TEE probe insertion time.
KEYWORDS: Heart disease patient; Modified Mallampati Classification; Unsedated transesophageal echocardiography
Regional Anesthesiology and Acute Pain Medicine Meeting
April 6-8, 2017, San Francisco, California, USA
ASRA American Society of Regional Anesthesia and Pain Medicine
California Society of Anesthesiologists
Annual Meeting April 27-30, 2017
San Francisco California
2017 International Peer Review Congress
September 10-12, 2017, Chicago, Illinois, USA
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