Airway physical examination tests for detection of difficult airway management in apparently normal patients

Abstract

This is the protocol for a review and there is no abstract. The objectives are as follows:

The objective of this review is to characterize the accuracy of the Mallampati classification and other commonly used airway examination tests (Table 1) for assessing the physical status of the airway in adult patients with no apparent anatomical airway abnormalities. This will be performed individually for each of the four descriptors of the DA (difficult face mask ventilation, difficult laryngoscopy, difficult tracheal intubation and failed intubation).

The secondary objective of this review is to determine which test or combination of tests has the highest accuracy in studies with direct comparisons for assessing the physical status of the airway in patients with no apparent anatomical airway abnormalities.

We will use subgroup analyses to investigate the following potential clinical and methodological sources of heterogeneity.

• The study population: obesity, parturients (women in labour), patients with a previous history of difficult intubation, concomitant medical conditions such as diabetes mellitus.

• The type of clinical care: during anaesthesia, following major trauma, with onset of critical illness and resuscitation for cardiac arrest.

• Study design: cross-sectional (or consecutive series) versus case-control.

• Maneuvers associated with the Cormack and Lehane (Cormack 1984) grade scoring system (i.e. head and neck positioning, application of external cricoid pressure, movement of the thyroid cartilage).