Predictors of difficult and impossible mask ventilation

Difficult mask ventilation	Impossible mask ventilation
Mallampati grade 3 to 4 Decreased mandibular protrusion Presence of beard Obesity (BMI ≥30) Age >57 years Lack of teeth History of snoring	Mallampati grade 3 to 4 Male sex Presence of beard OSA* Neck radiation changes

At least three predictors should be present in each category for a reasonably high probability of the event.

BMI: body mass index; OSA: obstructive sleep apnea; CPAP: continuous positive airway pressure; BiPAP: bilevel positive airway pressure.
* Moderate-to-severe OSA, associated with the use of CPAP/BiPAP or a history of OSA surgery.

Adapted from:

Langeron O, Masso E, Huraux C, et al. Prediction of difficult mask ventilation. Anesthesiology 2000; 92:1229.
Kheterpal S, Han R, Tremper KK, et al. Incidence and predictors of difficult and impossible mask ventilation. Anesthesiology 2006; 105:885.
Kheterpal S, Martin L, Shanks AM, Tremper KK. Prediction and outcomes of impossible mask ventilation: a review of 50,000 anesthetics. Anesthesiology 2009; 110:891.

Courtesy of Dr. Vladimir Nekhendzy.

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Predictors of difficult and impossible mask ventilation