Background: Clinical airway screening tests intend to predict difficult airways, but none have a high predictive value. Recent systematic reviews correlate ultrasound with difficult laryngoscopy. This study aimed primarily to correlate ultrasound measurements of anatomical upper airway structures in the sniffing position with difficult direct laryngoscopy. The secondary aim was to observe gender-based differences. Methods: This prospective, cross-sectional, single-center observational study included 209 patients requiring general anesthesia for elective surgery. Preoperatively, we performed six clinical airway assessments and three ultrasound measurements, which were the Distance from Skin to the Hyoid Bone (DSHB), to the Epiglottis (DSE), and to the anterior commissure of the vocal cords (DSAC) in a sniffing position. Benumof's criteria for the ¿best view at the first attempt¿ for direct laryngoscopy assessed the difficulty of laryngoscopy. Results: The distance from skin to the epiglottis was the best predictor of direct difficult laryngoscopy (defined as Cormack-Lehane grade ¿ 2b) with a minimum thickness cut-off at 2.70 ± 0.19 cm (sensitivity 91.3%; specificity 96.9%). The skin to the hyoid bone distance cut-off was 1.41 ± 0.30 cm with moderate correlation (sensitivity 80.4%; specificity 60.1%). No correlation was found for the distance to the anterior commissure of the vocal cords. In women compared to men, the skin to the epiglottis distance was more sensitive (92.3% vs. 90.9%) and specific (98.8% vs. 95.2%). Conclusions: DSE in the sniffing position is the most reliable parameter for preoperative airway ultrasound assessment in the Caucasian population, with higher sensitivity and specificity in women, and might be considered as an independent predictor for direct difficult laryngoscopy.

Traducción del artículo : J. L. D. Thomsen, A. K. Nørskov and C. V. Rosenstock. Supraglottic airway devices in difficult airway management: a retrospective cohort study of 658,104 general anaesthetics registered in the Danish Anaesthesia Database. Anaesthesia 2019, 74, 151¿157 doi:10.1111/anae.14443

Airway management in the obstetric patient is a challenge for anaesthesiologists, not only because of the anatomical and physiological changes during pregnancy, but also because of the surgery's urgency, the location of the procedure, which sometimes takes place even outside the operation theatre, and also due to conflicts emerging between the needs of the mother and fetus. The arising maternal comorbidities such as obesity, contribute to complications in airway management in this population.

Coautor del Tema 1. Ecografía pulmonar en el paciente crítico. Módulo 3 Manejo del paciente crítico en ventilación mecánica. Capítulo realizado para el "Experto en ventilación mecánica";2022;Madrid;Editorial Panamericana; Acreditado con 28 ECTS por la Universidad Católica de San Antonio de Murcia. (ISBN: 9788491109655)

Tema 48. Ecografía pulmonar en el paciente crítico. Sección VI. Inicio a la ventilación mecánica en unidad de cuidados crítico. Máster en el manejo de la vía aérea y ventilación mecánica. 70 ECTS por la Universidad Católica San Antonio de Murcia (UCAM). ISBN: 9788491109464.

Tema 11. Ecografía en vía aérea. Módulo 2 Conceptos avanzados en vía aérea del Máster en el manejo de la vía aérea y ventilación mecánica. 70 ECTS por la Universidad Católica San Antonio de Murcia (UCAM). ISBN: 9788491109464.

Capitulo de tratamiento del paciente en shock.