Acute Awake Fiberoptic Intubation in the ICU in a Patient with Limited Mouth Opening and Hypoxemic Acute Respiratory Failure

Table 2

Some data on predicted difficulties with intubation and backup plans for oxygenation. Highlighted (with a “+”), which of these features our patient presented [3, 6, 7].

Predictors of difficult intubation		Predictors of difficult backup plans for oxygenation
Predictors of difficult direct laryngoscopy		Predictors of difficult facemask ventilation
History of difficult intubation	+	History of neck radiation	+
Limited mouth opening (interincisor gap)	+	History of snoring or obstructive sleep apnea	+
Modified Mallampati Score 3 + 4	+	Obesity
Limited cervical spine mobility	+	Older age	+
Upper lip bite test	+	Male sex	+
Limited mandibular protrusion	+	Full beard
Retrognathia	+	Lack of teeth	+
Short thyromental distance	+	Modified Mallampati Score 3 + 4	+
		Limited mandibular protrusion	+
		Short thyromental distance	+
Predictors of difficult video laryngoscopy		Predictors of difficult supraglottic device use
Neck pathology (e.g., scars, neck radiation, mass, thick neck)	+	Glottic, supraglottic or subglottic pathology (e.g., neck radiation)	+
Cormack-Lehane Grade 3 + 4 with Macintosh	+	Obesity
Limited cervical spine mobility	+	Older age	+
Limited mandibular protrusion	+	Male sex	+
Short thyromental distance	+	Poor dentition	+
		Limited mouth opening	+
		Limited cervical spine mobility	+
		Short thyromental distance	+
		Rotation of surgical table during case
		Applied cricoid pressure
Predictors of difficult ligthwand use		Predictors of difficult cricothyrotomy
Obesity (thick neck)		Neck surface pathology (e.g. scars, radiation, inflammation, hematoma)	+
Limited cervical spine mobility	+	Deviated airway (e.g. goiter, neoplasms)
Large tongue/epiglottis	+	Obesity (thick neck)
		Age <8–10 years
		Female sex
		Limited cervical spine mobility	+