Intubation Clinical Trial
Official title:
Evaluation of the Accuracy and the Intra and Inter Rater Reliability of the POGO Score
A classification method describing the larynx appearance during laryngoscopy accepted by all
anesthetists has not been defined yet. In one study, it was shown that anesthetists mis
classed the glottis image by 50%. The most commonly used classification method is the Cormack
Lehane (CL) classification. This classification classifies the larynx appearance during
direct laryngoscopy form 1 to 4. The modified CL classification is criticized as it does not
predict difficult intubation and especially grade 2 is operator dependent and partial view is
not well defined. The numerical expression of the percentage of the glottic aperture (POGO =
percentile of glottic opening) is another score. In this score, A POGO score of 100% accounts
for full visualization of the larynx starting from anterior commissure to the posterior
cartilage, while 0% indicated a complete absence of glottic opening.
The use of a standard and effective classification method will facilitate and accelerate
communication between anesthetists in difficult life-threatening situations such as difficult
airway / difficult intubation / difficult ventilation and contribute to patient safety. The
use of common terminology can also facilitate the evaluation of the performance of intubation
tools.
The aim of this study was to evaluate the accuracy and intra and inter rater reliability of
the POGO score.
Anesthesiologist will be asked to score still images of laryngeal views, which will be
obtained from patients requiring intubation for general anesthesia, after obtaining written
informed consent.
The images of the larynx will be captured first with the Macintosh blade and thereafter with
the D blade. A group of independent anesthesiologist will score these images with the Cormack
Lehane and POGO scores. The set of images will be prepared from patients with both difficult
and normal airway anatomy. Some images in the series will be repeated to assess intra rater
variability.
The anesthesiologist will be asked to rate 20 images both with the CL and POGO scores.
The experience of the raters in airway management, their experience with videolaryngoscopy
and scoring systems used currently when documenting videolaryngoscopy and demographic data
will be also obtained.
The POGO scores of the participants and investigators will be compared.
The outcome of interest is the correct POGO score rate of the participants.
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