Predicting difficult videolaryngoscopic intubation in patients with obesity using ultrasound: an observational, prospective study
Authors' conclusion
The combination of the LEMON score, skin-to-tongue thickness, and DSE demonstrated superior predictive accuracy compared to any single parameter for identifying difficult videolaryngoscopic intubation in obese patients.
Study context
- Population
- Patients with obesity scheduled for elective laparoscopic bariatric surgery under GA128 analysed
- Participants
- 140 patients
- Comparison
- Ultrasonographic and clinical airway measurements for predicting difficult videolaryngoscopic intubation
- Outcome
- Difficult videolaryngoscopic intubation (Videolaryngoscopic Intubation and Difficult Airway Classification scale)
Performance
As reported in the abstract
Prediction of difficult intubation
| Test or model | AUC |
|---|---|
| Skin-to-tongue thickness | 0.776 (95% CI 0.672-0.879) |
| DSE | 0.774 (95% CI 0.678-0.869) |
| LEMON + skin-to-tongue thickness + DSE | 0.845 (95% CI 0.760-0.929) |
AUC
Skin-to-tongue thickness0.776 (95% CI 0.672-0.879)
DSE0.774 (95% CI 0.678-0.869)
LEMON + skin-to-tongue thickness + DSE0.845 (95% CI 0.760-0.929)
Further findings
Independent risk factors for difficult intubation
- LEMON score, skin-to-tongue thickness and DSE identified as independent risk factors
Original publication
Predicting difficult videolaryngoscopic intubation in patients with obesity using ultrasound: an observational, prospective study. J Clin Monit Comput. Published 12 December 2025. doi:10.
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