Introduction:

1. Introduction: • The incidence and predictors of Glidescope failure are not well described. In a series of early Glidescope intubations, the failure rate is 3.7% but this study does not extend beyond the initial experience and involves consecutive patients.2 Studies have described Glidescope difficulty but not failure. We hypothesize that Glidescope failure can be predicted by physical examination measurements. Results: There were 60 failed Glidescope intubations among the 2,004 attempts (3%). 71% of the 2,004 patients had objective predictors of difficult direct laryngoscopy. Four predictors were found to be significantly associated with failed Glidescope intubation amongst multiple predictors. The strongest predictor is neck anatomy that is altered from surgical scar, radiation, or mass. Rescue of these failed intubations were diverse but most often involved direct laryngoscoy or flexible fiberopticlaryngoscopy. Predicting Failure of Glidescope Video Laryngoscopy1Michael Aziz, MD. Ansgar Brambrink, MDDepartment of Anesthesiology & Perioperative Medicine. Oregon Health & Science University. Portland, OR • Methods: • This investigation evaluates the use of the Glidescope at two large tertiary care academic medical centers utilizing anesthesia information management systems. 2,004 Glidescope intubations were analyzed for success and failure in various populations amongst 71,570 anesthesia records. Patient history and physical examination characteristics were evaluated to determine the predictors of Glidescope failure. A logistic regression analysis was performed. Conclusion: While the Glidescope has a high success rate even in difficult patient populations, it can fail. Providers should be competent at alternate laryngoscopy methods, especially for the patient with neck pathology. Future studies should compare the Glidescope to other rigid video layrngoscopes and to direct larynogoscopes. • References: • Aziz, M. Healy, D. Kheterpal, S. Fu, R. Dillman, D. Brambrink, A. The Routine Clinical Practice Effectiveness of the Glidescope in Difficult Airway Management: An Analysis of 2,004 Glidescope Intubations, Complications, and Failures from Two Institutions. • Cooper RM, Pacey JA, Bishop MJ, McCluskey SA: Early clinical experience with a new videolaryngoscope (GlideScope) in 728 patients. Can J Anaesth 2005; 52: 191-8