Truong and Truong described the VIA score for airway assessment and management. The authors are from the University of Texas MD Anderson Cancer Center.
VIA is an acronym for ventilation (V), intubation (I) and aspiration risk (A).
bag/mask ventilation readily assured
supraglottic device may be needed to ensure adequate ventilation
impossible to ventilate after induction of general anesthesia
successful with conventional direct laryngoscopy
advanced intubating device or special skills needed
impossible to intubate after induction of general anesthesia
risk can be overcome by rapid sequence induction with cricoid pressure (full stomach, etc)
• A patient may be impossible to ventilate because of an anterior mediastinal mass compressing the trachea or a tracheoesophageal fistula.
• A patient may be impossible to intubate because of a large supraglottic tumor or an airway disrupted by trauma.
• A patient may be at high risk for aspiration because of high-grade intestinal obstruction, active vomiting, or an esophageal anastomotic leak.
total score =
= SUM(points for all 3 parameters)
• minimum score: 0
• maximum score: 6
• The higher the score the greater the risk.
very low risk
induction of general anesthesia with required precautions
awake intubation by specialist in difficult airway management
awake intubation; surgeon available to establish a patent airway if problems arise
very high risk
5 or 6
exceptionally high risk
tracheostomy not effective; require femorofemoral cardiopulmonary bypass
• Any single item scored 2 might raise the risk more than 2 items scored 1.
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Specialty: Anesthesiology, Surgery, general