Difficult airway in adult ICU in Quindío: a cross-sectional study

ABSTRACT

Introduction: The risk of complications and death related to difficult airway (DA) in critically ill patients is higher than in controlled settings such as the operating room. Statistics on DA in intensive care in Colombia are scarce, as are the intervention data and resources available in the units. The main objective was to determine the prevalence and characteristics of anatomical and physiological difficult airway. Methods: An observational, cross-sectional, multicentre study was conducted in adult Intensive Care Units (ICU) in Quindío. Links to two Google® forms were sent to the Coordinating Intensivists, one general and one specific related to DA anatomical factors (Mallampati, obstructive apnoea, stiff cervical spine, obesity, external appearance, Cormack-Lehane > 2, etc.) and physiological (oxygenation disorder, state of collapse, anaemia, etc.). Results: Four units participated, with 62 beds (83.9% of the beds in the department);56 hospitalized patients were found, 38 patients (67.8%) were intubated. Of the patients, 29% had some type of difficult airway. Of the patients with difficult airway, 100% had physiological DA parameters and 27.3% anatomical difficult airway 18.2% Cormack-Lehane (CL) > 2, and 9.1% subglottic stenosis. Obesity was the best predictor of CL > 2. LR+ 4.5, LR−. 001. Conclusions: Physiological DA is highly prevalent in the adult ICU, which represents a challenge for the intensivist, and a high risk of complications for patients. In this study, obesity was the main predictor of anatomical DA in critically ill patients. Intensive care units must have sufficient resources and personnel trained in the management of difficult airway. © 2022 Asociación Colombiana de Medicina Crítica y Cuidado lntensivo