Pre-operative ultrasound prediction of difficult airway management in adult patients: A systematic review of clinical evidence
Authors' conclusion
The use of ultrasound parameters might be useful in predicting difficult laryngoscopy or difficult intubation.
Study context
- Population
- Adults undergoing orotracheal intubation after airway ultrasound evaluation (excluding history of difficult airway, cancer, trauma, pregnancy, SGA devices, video-laryngoscopy)31 observational studies
- Comparison
- Pre-operative airway ultrasound parameters for predicting difficult laryngoscopy, intubation or mask ventilation
- Outcome
- Accuracy of ultrasound parameters in discriminating 'difficult' vs 'not difficult' laryngoscopy, intubation or mask ventilation
Pooled result
As reported in the abstract
Difficult laryngoscopy or intubation
- 41 single parameters and 12 combinations of clinical and ultrasound parameters reported
- Skin-to-epiglottis distance, hyoid-to-skin distance (neutral head/neck) and hyomental distance extended/neutral ratio most associated with difficult laryngoscopy or intubation
- Combination of clinical and ultrasound parameters (modified Mallampati score, skin-to-epiglottis distance, USED-MSH score) showed high accuracy
Further pooled results
Difficult mask ventilation
- Only 2 studies; hyoid-to-skin distance (neutral), tongue base thickness (hyperextension) and hyomental distance (hyperextension with mandible subluxation) had highest correlation
Original publication
Pre-operative ultrasound prediction of difficult airway management in adult patients: A systematic review of clinical evidence. Eur J Anaesthesiol. Published 6 February 2023. doi:10.
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