Procjena i liječenje otežanog dišnog puta kod pretilih bolesnica: retrospektivno istraživanje u jednom centru

The primary aim of this single center retrospective study was to evaluate difficult mask ventilation (DMV) and difficult laryngoscopy (DL) in a unique group of obese patients. A total of 427 adult patients with body mass index (BMI) ≥25 and surgically treated for endometrial cancer from 2011 to 2014 were assessed. Additional increase in BMI, comorbidities, bedside screening tests for risk factors, and the tools used to manage the patients were noted and their effects on DMV and/or DL investigated. Every escalation in the number of risk factors increased the probability of DMV 2.2-fold, DL 1.8-fold and DMV+DL 3.0-fold. Among bedside tests, limited neck movement (LNM), short neck (SN) and absence of teeth were significant for DMV (p25% were considered. In conclusion, LNM and SN are independent risk factors for developing DMV and/or DL in obese endometrial cancer patients, while BMI increase over 30 was not additionally affecting difficult airway.Primarni cilj ovoga retrospektivnog istraživanja provedenog u jednom centru bila je procjena otežane ventilacije maskom (OVM) i otežane laringoskopije (OL) u specifičnoj populaciji pretilih bolesnica. U istraživanje je bilo uključeno 427 odraslih bolesnica s indeksom tjelesne mase (ITM) >25 koje su kirurški liječene zbog karcinoma endometrija od 2011. Do 2014. godine. Dodatno su bilježeni utjecaj porasta ITM, pridruženih bolesti, čimbenika rizika određenih kliničkim probirnim testovima i alata kojim su se zbrinjavale bolesnice na OVM i/ili OL. Svaka eskalacija u broju rizičnih čimbenika je povećavala rizik OVM za 2,2 puta, OL 1,8 puta i OVM+OL 3,0 puta. Od kliničkih testova, ograničena pokretljivost vrata (OPV), kratak vrat (KV) i nedostatak zuba su bili značajni za OVM (p25, tada deseterostruki porast nije bio nezavisni rizični čimbenik. Zaključno, OPV i KV su nezavisni čimbenici rizika za razvoj OVM i/ili OL u pretilih bolesnica s karcinomom endmetrija, dok ITM veći od 30 nije dodatno uticao na otežani dišni put