Difficult Mask Ventilation

Department of Anesthesiology-West, Medical College of Wisconsin, Froedtert Memorial Lutheran Hospital, 9200 W Wisconsin Ave., Milwaukee, WI 53226, USA.
Anesthesia and analgesia (Impact Factor: 3.47). 12/2009; 109(6):1870-80. DOI: 10.1213/ANE.0b013e3181b5881c
Source: PubMed


Mask ventilation is the most fundamental skill in airway management. In this review, we summarize the current knowledge about difficult mask ventilation (DMV) situations. Various definitions for DMV have been used in the literature. The lack of a precise standard definition creates a problem for studies on DMV and causes confusion in data communication and comparisons. DMV develops because of multiple factors that are technique related and/or airway related. Frequently, the pathogenesis involves a combination of these factors interacting to cause the final clinical picture. The reported incidence of DMV varies widely (from 0.08% to 15%) depending on the criteria used for its definition. Obesity, age older than 55 yr, history of snoring, lack of teeth, the presence of a beard, Mallampati Class III or IV, and abnormal mandibular protrusion test are all independent predictors of DMV. These signs should, therefore, be recognized and documented during the preoperative evaluation. DMV can be even more challenging in infants and children, because they develop hypoxemia much faster than adults. Finally, difficult tracheal intubation is more frequent in patients who experience DMV, and thus, clinicians should be familiar with the corrective measures and management options when faced with a challenging, difficult, or impossible mask ventilation situation.

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    • "Mask ventilation is the initial and mostessential step in airway management. Every anesthesiologist should acquire the skills for mask ventilation [1]. DMV is a situation in which it is not possible for the anesthesiologist to provide adequate face mask ventilation due to an inadequate mask seal, excessive gas leakage or excessive resistance to ingress or egress of gas [3]. "

    Full-text · Article · Jan 2015 · Open Journal of Anesthesiology
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    • "Mask ventilation as an initial ventilation support is widely used for unconscious subjects either in an emergency or during induction of general anesthesia [1]. About 250,000 cases of cardiac arrest annually occur outside of hospitals, and 370,000 to 750,000 cases occur in hospitals [2,3]. "
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