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Background: Airway management is commonly performed procedures in the intensive care unit (ICU). Difficult airway along with hypoxemia and cardiovascular collapse is most serious life threating complication in critically ill patients. Average incidence of difficult airway is around 10 to 23% depending on protocols followed by the institute and availability of equipment’s in the centre. The aim of this study is to find out the incidence of difficult airway and to develop a score that predict difficult airway in critical care unit. Method and Material: A Prospective study was conducted in tertiary care hospital and attached medical college for a period of two year (from July 2017 to July 2019) in 30 bedded mixed ICU and 9 bedded cardiac care unit, in patients of age group (18-90 year) who require mechanical ventilatory support. The airway management in ICU was done by an experienced anaesthetist or intensivist having work experience of more than five years. Results: In two-years, total 3,504 patients admitted in our ICU and out of them 1872(53.42%) patients require invasive ventilatory support. Anatomical difficult airway was encountered in total 504 (26.92%) patients, out of which 281 (55.75%) were male and 223 (44.24%) were female. DBMV is seen in 167 (8. 92%) patient, DSDP in 79 (4.22%), DI in 161 (8.6%), DSA in 97(5.18%) of the patients and physiological difficult airway (PDA) in 1204 (64.31%) patients and anatomical with physiological difficult airway (ADA+PDA) was found in total 164(8.76%) patients. In our study 8.76% was very difficult due to anatomical and physiological reasons, 26.92% was difficult due to anatomical factors of patients and 64.31% are moderately difficult due to physiological factors associated with underlying disease of the patients. Conclusion: Incidence of difficult airway is very high in ICU as compare to OT due to anatomical factors and physiological factors of the patients, so each and every patient requires different strategies of airway management in ICU.

A prospective cross-sectional study of incidence of difficult airway in intensive care unit in North India