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
(1) clinical assessment
(2) body weight and growth assessment
(3) dyspnea scores
(4) Cormack-Lehane classification
small micromaxillary deformity or bird face with jaw retraction
cleft palate or high palatine arches
need of oxygenation or ventilation due to tongue posterior displacement
body weight and growth
weight gain > 20 g/d
weight gain 10-20 g/d
weight gain 5-10 g/d
weight gain < 5 g/d
surgical intervention required (weight loss since birth)
SpO2 > 95%
inspiratory dyspnea with SpO2 92-95%
inspiratory dyspnea with SpO2 88-92%, with change in position causing < 5% change in SpO2
inspiratory dyspnea with SpO2 < 88%, with change in position causing > 5% change in SpO2
continuous positive airway pressure (CPAP)
visibility of all of the glottis
visibility of most of the glottis
visibility only a glimpse of the posterior glottis joint
visibility only a glimpse of the epiglottis, without the appearance of the glottis
unable to see any anatomical portion of the throat
= SUM(points for clinical assessment) + SUM(points for the other parameters)
• 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.
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