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.
Study Type
OBSERVATIONAL
Enrollment
926
University Medical Center Hamburg-Eppendorf
Hamburg, Hamburg, Germany
RECRUITINGDifficult facemask ventilation
Alert documented in patients health records by the airway operator following facemask ventilation
Time frame: 1 hour
Impossible facemask ventilation
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)
Time frame: 1 hour
Best capnograph achieved
Best capnography waveform achieved during facemask ventilation (grade A-D)
Time frame: 1 hour
Optimization manoeuvers for facemask ventilation used
Optimization manouvers such as oral airway, jaw-thrust or two-handed grip used as documented facemask ventilation
Time frame: 1 hour
Leak fraction
Leak fraction (leak volume/ tidal volume) during facemask ventilation
Time frame: 1 hour
Tidal volume
Tidal volume during facemask ventilation (ml)
Time frame: 1 hour
Senior anaesthetist taking over
Senior anaesthetist taking over facemask ventilation as documented after facemask ventilation
Time frame: 1 hour
Timing of neuromuscular blocking agent
Observed during airway management (before/ after facemask ventilation)
Time frame: 1 hour
Ventilation mode during facemask ventilation
Manual or controlled ventilation applied by the airway operator
Time frame: 1 hour
Change of ventilation mode during mask ventilation
Observed during mask ventilation (to manual or controlled)
Time frame: 1 hour
Difficult tracheal intubation
Multiple tracheal intubation attempts documented after tracheal intubation
Time frame: 1 hour
Difficult laryngoscopy
Observed difficult laryngoscopy with restricted glottis view documented after tracheal intubation
Time frame: 1 hour
First attempt success
Successful tracheal intubation with only one attempt observed during tracheal intubation
Time frame: 1 hour
Number of intubation attempts
Observed during airway management
Time frame: 1 hour
Number of laryngoscopy attempts
Observed during airway management
Time frame: 1 hour
Glottic view during laryngoscopy
Grading of the best view obtained using landmarks (6-stages)
Time frame: 1 hour
Percentage of glottis opening
Grading of the best view obtained during laryngoscopy (%)
Time frame: 1 hour
VIDiAC Score
Classification of difficult (video-)laryngoscopic intubation (total score -1 to 5)
Time frame: 1 hour
Failed primary intubation technique
First-choice tracheal intubation technique unsuccessful
Time frame: 1 hour
Lowest peripheral oxygen saturation
Observed during airway management (%)
Time frame: 1 hour
Drop of peripheral oxygen saturation during facemask ventilation
Observed during facemask ventilation (%)
Time frame: 1 hour
Airway-related adverse events
Laryngospasm, bronchospasm, larynx trauma, airway trauma, soft tissue trauma, oral bleeding, edema, dental damage, corticosteroid application, accidental esophageal intubation, aspiration, hypotension or hypoxia
Time frame: 1 hour
Post-intubation recommendation for an intubation method
Recommendation issued by the airway operator after airway management for either awake tracheal intubation, camera-assisted intubation, direct laryngoscopy or other techniques
Time frame: 1 hour
Anaesthesia alert card issued
Anaesthesia alert card issued by the airway operator after airway management Anaesthesia alert card issued by the airway operator after airwaymanagement
Time frame: 1 hour
Difficult tracheal intubation alert
"Difficult tracheal intubation alert" issued by the airway operator after tracheal intubation in health records
Time frame: 1 hour
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