The correlation between anthropometric indices and hemodynamic changes after laryngoscopy and endotracheal intubation

Authors
Mohammadreza Safavi
Azim Honarmand
Elham Ghorbani Dasgerdi
Ghasem Mohammad Sharifi
Department of Anesthesia, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Cardiovascular hemodynamic changes after laryngoscopy and endotracheal intubations can cause serious complications. This study was carried out to evaluate the correlation between the anthropometric indices and hemodynamic changes after laryngoscopy and endotracheal intubation (EI).
Materials and Methods: This descriptive–analytical pilot study was carried out in 2012, in the Kashani Hospital, Isfahan, Iran. After obtaining written informed consent from 130 patients who fulfilled the inclusion criteria, they were enrolled in the study. The recorded data included were, age, weight, height, neck circumference (NC), waist-to-hip ratio (W/H ratio) and body mass index (BMI). The heart rate (HR), systolic blood pressure (SAP), diastolic blood pressure (DBP), and mean arterial blood pressure (MAP) were recorded at baseline (before injection of the anesthetic drugs), just before laryngoscopy, and one, three, five, and ten minutes after EI.




Results: The best cut-off points for BMI, NC, and W/H ratio, for prediction of significant cardiovascular changes after EI were, 26.56 kg/m2, 38 cm, and 0.82, respectively. There was a significant correlation between BMI and HR changes in the first and fifth minutes and also in MAP in the third and fifth minutes after EI (P < 0.05). Moreover, there was a significant correlation between NC and MAP in the fifth minute (P < 0.05). The W/H ratio was significantly related to the DBP in the tenth minute and MAP in the fifth and tenth minutes (P < 0.05).
Conclusions: Based on the results of this study, among the anthropometric indices, the BMI, NC, and W/H ratio were significantly correlated with cardiovascular changes after laryngoscopy and tracheal intubation.

Keywords

1.
Mort TC. Emergency tracheal intubation: Complications associated with repeated laryngoscopic attempts. Anesth Analg 2004;99:607-13.  Back to cited text no. 1
    
2.
Schwartz DE, Matthay MA, Cohen NH. Death and other complications of emergency airway management in critically ill adults. A prospective investigation of 297 tracheal intubations. Anesthesiology 1995;82:367-76.  Back to cited text no. 2
    
3.
Mort TC. Unplanned tracheal extubation outside the operating room: A quality improvement audit of hemodynamic and tracheal airway complications associated with emergency tracheal reintubation. Anesth Analg 1998;86:1171-6.  Back to cited text no. 3
    
4.
Sakles JC, Laurin EG, Rantapaa AA, Panacek EA. Airway management in the emergency department: A one-year study of 610 intubations. Ann Emerg Med 1998;31:325-32.  Back to cited text no. 4
    
5.
Tayal VS, Riggs RW, Marx JA, Tomaszewski CA, Schneider RE. Rapid-sequence intubation at an emergency medicine residency: Success rate and adverse events during a two-year period. Acad Emerg Med 1999;6:31-7.  Back to cited text no. 5
    
6.
Redan JA, Livingston DH, Tortella BJ, Rush BF Jr. The value of intubating and paralyzing patients with suspected head injury in the emergency department. J Trauma 1991;31:371-5.  Back to cited text no. 6
    
7.
Gonzalez H, Minville V, Delanoue K, Mazerolles M, Concina D, Fourcade O. The importance of increased neck circumference to intubation difficulties in obese patients. Anesth Analg 2008;106:1132-6,  Back to cited text no. 7
    
8.
Kissebah AH, Vydelingum N, Murray R, Evans DJ, Hartz AJ, Kalkhoff RK, et al. Relation of body fat distribution to metabolic complications of obesity. J Clin Endocrinol Metab 1982;54:254-60.  Back to cited text no. 8
[PUBMED]    
9.
Wilson ME, Spiegelhalter D, Robertson JA, Lesser P. Predicting difficult intubation. Br J Anaesth 1988;61:211-6  Back to cited text no. 9
    
10.
Ben-Noun LL, Laor A. Relationship between changes in neck circumference and cardiovascular risk factors. Exp Clin Cardiol 2006;11:14-20.  Back to cited text no. 10
    
11.
Ben-Noun L, Sohar E, Laor A. Neck circumference as a simple screening measure for identifying overweight and obese patients. Obes Res 2001;9:470-7.  Back to cited text no. 11
    
12.
Ashwell M, Cole TJ, Dixon AK. Obesity: New insight into the anthropometric classification of fat distribution shown by computed tomography. Br Med J (Clin Res Ed) 1985;290:1692-4.  Back to cited text no. 12
[PUBMED]    
13.
Wing RR, Jeffery RW, Burton LR, Thorson C, Kuller LH, Folsom AR. Change in waist-hip ratio with weight loss and its association with change in cardiovascular risk factors. Am J Clin Nutr 1992;55:1086-92.  Back to cited text no. 13
    
14.
Haffner SM, Stern MP, Hazuda HP, Pugh J, Patterson JK. Do upper-body and centralized adiposity measure different aspects of regional body-fat distribution? Relationship to non-insulin-dependent diabetes mellitus, lipids, and lipoproteins. Diabetes 1987;36:43-51.  Back to cited text no. 14
[PUBMED]    
15.
Ben-Noun LL, Laor A. Relationship between changes in neck circumference and changes in blood pressure. Am J Hypertens 2004;17:409-14.  Back to cited text no. 15
    
16.
Ben-Noun L, Laor A. Relationship of neck circumference to cardiovascular risk factors. Obes Res 2003;11:226-31.  Back to cited text no. 16
    
17.
Gurulingappa, Aleem MA, Awati MN, Adarsh S. Attenuation of cardiovascular responses to direct laryngoscopy and intubation-a comparative study between iv bolus fentanyl, lignocaine and placebo(NS). J Clin Diagn Res 2012;6:1749-52.  Back to cited text no. 17
Advanced Biomedical Research
Volume 2016, March
March 2016
Pages 1-6