Prediction of Difficult Mask Ventilation

Prediction of Difficult Mask Ventilation
Anesthesiology 2000; 92:1229–36

Olivier Langeron, M.D.,* Eva Masso, M.D.,† Catherine Huraux, M.D.,‡ Michel Guggiari, M.D.,‡
Andre´ Bianchi, M.D.,‡ Pierre Coriat, M.D.,§ Bruno Riou, M.D., Ph.D.i

Background: Maintenance of airway patency and oxygenation are the main objectives of face-mask ventilation. Because the incidence of difficult mask ventilation (DMV) and the factors associated with it are not well known, we undertook this
prospective study.
Methods: Difficult mask ventilation was defined as the inability of an unassisted anesthesiologist to maintain the measured oxygen saturation as measured by pulse oximetry > 92% or to prevent or reverse signs of inadequate ventilation during positive-
pressure mask ventilation under general anesthesia. A univariate analysis was performed to identify potential factors predicting DMV, followed by a multivariate analysis, and odds
ratio and 95% confidence interval were calculated.
Results: A total of 1,502 patients were prospectively included. DMV was reported in 75 patients (5%; 95% confidence interval, 3.9–6.1%), with one case of impossible ventilation. DMV was anticipated by the anesthesiologist in only 13 patients (17% of the DMV cases). Body mass index, age, macroglossia, beard, lack of teeth, history of snoring, increased Mallampati grade, and lower thyromental distance were identified in the univariate
analysis as potential DMV risk factors. Using a multivariate analysis, five criteria were recognized as independent factors for a DMV (age older than 55 yr, body mass index > 26 kg/m2,

This article is accompanied by an Editorial View. Please see:
Adnet F: Difficult mask ventilation: An underestimated aspect
of the problem of the difficult airway? ANESTHESIOLOGY 2000;
92:1217–8.

Nota: Sustentación enviada por el Dr. Xavier Márquez.