Airway Management, General Anesthesia, Mask Ventilation
Conditions
Keywords
Airway management, Mask ventilation
Brief summary
The MASCAN Score is a prospectively developed objective classification for difficult facemask ventilation. This prospective observational study aims to externally validate the MASCAN score in patients undergoing general anaesthesia for surgical procedures and to determine the influence of different approaches and techniques, such as the timing of neuromuscular blocking agents and manual versus controlled facemask ventilation. A secondary aim is to determine the diagnostic value of visual assessments of the capnography curve. Another secondary aim of the study is to compare the assessment of the first attempt success during tracheal intubation between the airway operator and an independent observer.
Interventions
None listed
Sponsors
Universitätsklinikum Hamburg-Eppendorf
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients who are scheduled for surgery with general anesthesia and require facemask ventilation and tracheal intubation after induction of anesthesia * Patients aged 18 years or older * Provided informed consent
Exclusion criteria
* Pregnant or breastfeeding woman * Required rapid sequence induction or other contraindications for facemask ventilation * Planned awake tracheal intubation * No consent given
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Difficult facemask ventilation | 1 hour | Alert documented in patients health records by the airway operator following facemask ventilation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Best capnograph achieved | 1 hour | Best capnography waveform achieved during facemask ventilation (grade A-D) |
| Optimization manoeuvers for facemask ventilation used | 1 hour | Optimization manouvers such as oral airway, jaw-thrust or two-handed grip used as documented facemask ventilation |
| Leak fraction | 1 hour | Leak fraction (leak volume/ tidal volume) during facemask ventilation |
| Tidal volume | 1 hour | Tidal volume during facemask ventilation (ml) |
| Senior anaesthetist taking over | 1 hour | Senior anaesthetist taking over facemask ventilation as documented after facemask ventilation |
| Timing of neuromuscular blocking agent | 1 hour | Observed during airway management (before/ after facemask ventilation) |
| Ventilation mode during facemask ventilation | 1 hour | Manual or controlled ventilation applied by the airway operator |
| Change of ventilation mode during mask ventilation | 1 hour | Observed during mask ventilation (to manual or controlled) |
| Difficult tracheal intubation | 1 hour | Multiple tracheal intubation attempts documented after tracheal intubation |
| Difficult laryngoscopy | 1 hour | Observed difficult laryngoscopy with restricted glottis view documented after tracheal intubation |
| First attempt success | 1 hour | Successful tracheal intubation with only one attempt observed during tracheal intubation |
| Impossible facemask ventilation | 1 hour | Impossible facemask ventilation observed after induction of anesthesia (absence of end-tidal carbon dioxide measurement and lack of perceptible chest wall movement despite airway adjuvants and additional personnel after adequate neuromuscular blockade) |
| Number of laryngoscopy attempts | 1 hour | Observed during airway management |
| Glottic view during laryngoscopy | 1 hour | Grading of the best view obtained using landmarks (6-stages) |
| Percentage of glottis opening | 1 hour | Grading of the best view obtained during laryngoscopy (%) |
| VIDiAC Score | 1 hour | Classification of difficult (video-)laryngoscopic intubation (total score -1 to 5) |
| Failed primary intubation technique | 1 hour | First-choice tracheal intubation technique unsuccessful |
| Lowest peripheral oxygen saturation | 1 hour | Observed during airway management (%) |
| Drop of peripheral oxygen saturation during facemask ventilation | 1 hour | Observed during facemask ventilation (%) |
| Airway-related adverse events | 1 hour | Laryngospasm, bronchospasm, larynx trauma, airway trauma, soft tissue trauma, oral bleeding, edema, dental damage, corticosteroid application, accidental esophageal intubation, aspiration, hypotension or hypoxia |
| Post-intubation recommendation for an intubation method | 1 hour | Recommendation issued by the airway operator after airway management for either awake tracheal intubation, camera-assisted intubation, direct laryngoscopy or other techniques |
| Anaesthesia alert card issued | 1 hour | Anaesthesia alert card issued by the airway operator after airway management Anaesthesia alert card issued by the airway operator after airwaymanagement |
| Difficult tracheal intubation alert | 1 hour | Difficult tracheal intubation alert issued by the airway operator after tracheal intubation in health records |
| Number of intubation attempts | 1 hour | Observed during airway management |
Countries
Germany
Contacts
Primary ContactMartin Petzoldt, MD
Backup ContactViktor A Wünsch, MD
Outcome results
None listed