Pediatric anesthesia & critical care
Guedel oropharyngeal airway: The validation of facial landmark-distances to estimate sizing in children – Visualisation by magnetic resonance imaging (GUEDEL-I): A prospective observational study
Authors' conclusion
Although the facial landmark-distance "maxillary incisors to the angle of the mandible" does not reliably predict oropharyngeal airway size, no clinical problems have been encountered.
Study context
- Population
- Anaesthetised, spontaneously breathing children ≤12 years undergoing cranial MRImean (SD) age 4.7 (±3) years
- Participants
- 94 participants
- Outcome
- Rate of properly sized oropharyngeal airways on MRI (distal end within 10 mm from the epiglottis without contacting it), sized by maxillary incisors to mandibular angle distance
Main finding
As reported in the abstract
Oropharyngeal airway sizing on MRI
Properly sized
47.9%
95% CI 38%–57.9%
Undersized
23.4%
95% CI 15.9%–33%
Oversized
28.7%
95% CI 20.5%–38.7%
Observational data: associations, not effects.
Secondary outcomes
Tongue protrusion
- Undersized airways
- 59.1% (95% CI 38.2%-77.2%)
- Properly sized airways
- 15.6% (95% CI 7.6%-29.2%)
Probability of proper sizing by landmark-distance or formula
- Maxillary incisors to angle of mandible, best of five landmark-distances
- 41.2% (95% CI 32%-51.7%)
- Best-fit formula 22.43 + 17.54 × log(weight[kg])
- 61.7% (95% CI 51.5%-70.9%)
Safety
- No oropharyngeal airway required replacement
Original publication
Guedel oropharyngeal airway: The validation of facial landmark-distances to estimate sizing in children – Visualisation by magnetic resonance imaging (GUEDEL-I): A prospective observational study. Resuscitation. Published 23 January 2023. doi:10.
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