Children's Hospital of Philadelphia
Upper airway ultrasound (UA-US) has been utilized in adults to predict difficult laryngoscopy (Cormick-Lehane view 3 or 4) and difficult tracheal intubation (DTI) (≥3 intubation attempts) and with moderate-to-high sensitivity and specificity. This bedside technique is reproducible, easy-to-do without any additional radiation risk, and was added to the most recent American Society of Anesthesiologists (ASA) Practice Guidelines for Difficult Airway Management in Adults. However, UA-US has only been applied to older children ages 5-12 and has not been examined in neonates and infants. Thus, the aim of this observational study using UA-US to predict difficult laryngoscopy and tracheal intubation in neonates and infants presenting for diagnostic, procedural or surgical care under general anesthesia requiring endotracheal intubation.
Neonates and infants have a higher incidence of difficult laryngoscopy and DTI compared to older children and adults. Classical methods of screening for difficult laryngoscopy or DTI in adults, such as a Mallampati score, thyromental distance, and neck circumference are poorly applied to our smallest patients. UA-US has emerged as a technique to measure several UA parameters at the bedside with impressive sensitivity and specificity for identifying a difficult airway in adult patients, with higher UA-US measurements correlating with higher Cormick-Lehane laryngoscopy scores. UA-US was recently…
Inclusion Criteria: * Neonates (chronological age 30 days) and infants (31 days to 365 days) * ASA physical status I-IV * Oral endotracheal intubation for surgical, diagnostic or interventional procedures with neuromuscular blockade * Video laryngoscopy * Patients with previously classified non-difficult airway (previous easy intubation) * Patients with a previously classified difficult airway * Patients with congenital heart disease * Parental/guardian permission Exclusion Criteria: * ASA ≥V * Emergency procedure * Unable to be placed in supine position for study ultrasound * Need for rapi…
The investigator will perform 6 UA-US measurements will be obtained with a high frequency linear array or curvilinear US probe following induction of anesthesia but prior to laryngoscopy or TI: distance from the skin to the epiglottis, distance from the skin to the hyoid bone, distance from skin to vocal cords, hyomental distance, tongue thickness, and tongue cross-sectional area.
Arctuva estimate
Actual pay is set by the research site.
Verify or correct the compensation shown for this listing.