Intubação difícil em crianças: aplicabilidade do índice de Mallampati

Ana Paula S Vieira Santos; Ligia Andrade S Telles Mathias; Judymara Lauzi Gozzani; Marcelo Watanabe

doi:10.1590/S0034-70942011000200005

Scientific Article

Intubação difícil em crianças: aplicabilidade do índice de Mallampati

Difficult intubation in children: applicability of the Mallampati index

Ana Paula S Vieira Santos; Ligia Andrade S Telles Mathias; Judymara Lauzi Gozzani; Marcelo Watanabe

http://dx.doi.org/10.1590/S0034-70942011000200005 Braz J Anesthesiol, vol.61, n2, p.159-162, 2011

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Resumo

JUSTIFICATIVA E OBJETIVOS: A preocupação de estar diante de uma via aérea difícil trouxe à tona a necessidade de se desenvolverem testes preditivos de intubação difícil. Tais testes foram, primariamente, desenvolvidos para populações adultas. Nos pacientes pediátricos, os estudos existentes sempre trataram de pacientes com malformações congênitas, politraumatizados e recém-nascidos. O objetivo deste trabalho foi verificar, em pacientes na faixa etária de 4 a 8 anos, a aplicabilidade do teste preditivo de intubação difícil mais comumente utilizado em adultos, o índice de Mallampati, correlacionando-o com o índice de Cormack-Lehane. MÉTODO: Foram estudados 108 pacientes com idades entre 4 e 8 anos, ASA I, sem quaisquer tipos de malformações anatômicas, síndromes genéticas ou déficits cognitivos. Os pacientes foram submetidos, durante a avaliação pré-anestésica, ao índice de Mallampati. Após a indução anestésica, realizava-se a avaliação do índice de Cormack-Lehane. Nos testes estatísticos p < 0,05, foi considerado significativo. RESULTADOS: O índice de Mallampati apresentou correlação significativa com o índice de Cormack-Lehane. A sensibilidade e a especificidade do índice de Mallampati foram, respectivamente, de 75,8% e 96,2%, mas o intervalo de confiança da sensibilidade foi muito grande. CONCLUSÕES: O índice de Mallampati se mostrou aplicável em crianças de 4 a 8 anos.

Palavras-chave

ANESTESIA, Pediátrica, AVALIAÇÃO, Pré-anestésica, CIRURGIA, Cuidados pré-operatórios, COMPLICAÇÕES, Intubação Endotraqueal, Criança, INTUBAÇÃO TRAQUEAL, TÉCNICAS DE MEDIÇÃO

Abstract

BACKGROUND AND OBJECTIVES: The concern of facing difficult airways brought the need of developing predictive testing for difficult intubation. Those tests were developed primarily for adult populations. In pediatric patients studies always focus on patients with congenital malformation, polytraumatized, and newborns. The objective of the present study was to determine the applicability of the predictive test used more often in adults, the Mallampati index, in patients 4 to 8 years old, correlating it with the Cormack-Lehane index. METHODS: One hundred and eight patients 4 to 8 years of age, ASA I, without any type of congenital malformation, genetic syndromes or cognitive deficits were evaluated. The Mallampati index was applied to patients during the pre-anesthetic evaluation. Evaluation of the Cormack-Lehane index was performed after anesthetic induction. A p < 0.05 was considered significant. RESULTS: The Mallampati index showed a significant correlation with the Cormack-Lehane index. The sensitivity and specificity of the Mallampati index were 75.8% and 96.2% respectively, but the sensitivity showed a wide confidence interval. CONCLUSIONS: The Mallampati index was proven to be applicable in children 4 to 8 years old.

Keywords

Intubation, Intratracheal, Pediatrics, Predictive Value of Tests, Preoperative care

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Intubação difícil em crianças: aplicabilidade do índice de Mallampati

Difficult intubation in children: applicability of the Mallampati index

Ana Paula S Vieira Santos; Ligia Andrade S Telles Mathias; Judymara Lauzi Gozzani; Marcelo Watanabe

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