Yin et al reported a score for evaluating a neonate with Pierre Robin Sequence. The authors are from Nanjing Medical University, Southeast University and affiliated hospitals in Nanjing.
Patient selection: Pierre Robin Sequence
Parameters:
(1) clinical assessment
(2) body weight and growth assessment
(3) dyspnea scores
(4) Cormack-Lehane classification
|
Clinical Assessment |
Finding |
Points |
|
small micromaxillary deformity or bird face with jaw retraction |
absent |
0 |
|
|
present |
1 |
|
cleft palate or high palatine arches |
absent |
0 |
|
|
present |
1 |
|
need of oxygenation or ventilation due to tongue posterior displacement |
absent |
0 |
|
|
present |
1 |
|
feeding difficulties |
absent |
0 |
|
|
present |
1 |
|
Parameter |
Finding |
Points |
|
body weight and growth |
weight gain > 20 g/d |
0 |
|
|
weight gain 10-20 g/d |
1 |
|
|
weight gain 5-10 g/d |
2 |
|
|
weight gain < 5 g/d |
3 |
|
|
surgical intervention required (weight loss since birth) |
4 |
|
dyspnea scores |
SpO2 > 95% |
0 |
|
|
inspiratory dyspnea with SpO2 92-95% |
1 |
|
|
inspiratory dyspnea with SpO2 88-92%, with change in position causing < 5% change in SpO2 |
2 |
|
|
inspiratory dyspnea with SpO2 < 88%, with change in position causing > 5% change in SpO2 |
3 |
|
|
continuous positive airway pressure (CPAP) |
4 |
|
Cormack-Lehane |
visibility of all of the glottis |
0 |
|
|
visibility of most of the glottis |
1 |
|
|
visibility only a glimpse of the posterior glottis joint |
2 |
|
|
visibility only a glimpse of the epiglottis, without the appearance of the glottis |
3 |
|
|
unable to see any anatomical portion of the throat |
4 |
score =
= SUM(points for clinical assessment) + SUM(points for the other parameters)
Interpretation:
• minimum score: 0
• maximum score: 16
• The higher the score the more severe the problems in the perioperative period.
• A score < 10 indicates mild disease.
• A score >= 10 is associated with post-extubation dyspnea and low postoperative SpO2.
• A score >= 13 required laryngeal mask assisted airway management.
Specialty: Anesthesiology
