Association Between Age- and Sex-Specific Body Mass Index Percentile and Multiple Intubation Attempts: A...

Area of Science:

• Pediatric Anesthesiology
• Obesity Research
• Airway Management

Background:

• Obesity is known to complicate airway management in adults.
• The impact of obesity on pediatric intubation difficulty is less understood.
• This study investigated the relationship between body mass index (BMI) and intubation outcomes in children.

Purpose of the Study:

• To determine if higher age- and sex-specific BMI percentile is associated with difficult pediatric intubation.
• To assess if this association is modified by age group or presence of airway abnormalities.

Main Methods:

• Retrospective analysis of 9339 pediatric patients (2-18 years) undergoing noncardiac surgery with oral endotracheal intubation.
• Used multivariable logistic regression to assess the association between BMI percentile and difficult intubation (>1 attempt).
• Examined interactions with preoperative airway status and age groups.

Main Results:

• No significant association was found between BMI percentile and difficult intubation (OR 0.98; 95% CI, 0.95-1.005).
• This finding was consistent across early childhood, middle childhood, and early adolescence age groups.
• Patients with airway abnormalities showed reduced odds of difficult intubation with increasing BMI percentile (OR 0.83; P = .01).

Conclusions:

• Age- and sex-specific BMI percentile is not associated with difficult intubation in children aged 2-18 years.
• Similar to adults, obesity does not appear to significantly complicate intubation in this pediatric population.
• Preexisting airway abnormalities may influence the relationship between BMI and intubation difficulty.