{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T06:20:49Z","timestamp":1788502849976,"version":"build-2803163510"},"reference-count":18,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2020,5,1]],"date-time":"2020-05-01T00:00:00Z","timestamp":1588291200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We investigated the \u201cBURP\u201d maneuver\u2019s effect on the association between difficult laryngoscopy and difficult intubation, and predictors of a difficult airway.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adult patients who underwent general anesthesia and tracheal intubation from September 2016 to May 2018 were included. The \u201cBURP\u201d maneuver was performed when glottic exposure was classified as Cormack\u2013Lehane grade 3 or 4, suggesting difficult laryngoscopy. The thyromental distance, modified Mallampati score, and interincisor distance were assessed before anesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among this study\u2019s 2028 patients, the \u201cBURP\u201d maneuver decreased difficult laryngoscopies from 428 (21.1%) to 124 (6.1%) cases and increased the difficult intubation to difficult laryngoscopy ratio from 53\/428 (12.4%) to 52\/124 (41.9%). For laryngoscopies classified as difficult without the \u201cBURP\u201d maneuver, the area under the curve (AUC) of the thyromental distance, modified Mallampati score, and interincisor distance was 0.60, 0.57, and 0.66, respectively. In difficult laryngoscopies using the \u201cBURP\u201d maneuver, the AUC of the thyromental distance, modified Mallampati score, and interincisor distance was 0.71, 0.67, and 0.76, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The \u201cBURP\u201d maneuver improves the laryngoscopic view and assists in difficult laryngoscopies. Compared with difficult laryngoscopies without the \u201cBURP\u201d maneuver, those with the \u201cBURP\u201d maneuver are more closely associated with difficult intubations and are more predictable. Trial registration: www.chictr.org.cn identifier: ChiCTR-ROC- 16009050.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0300060520925325","type":"journal-article","created":{"date-parts":[[2020,5,27]],"date-time":"2020-05-27T10:36:56Z","timestamp":1590575816000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["The \u201cBURP\u201d maneuver improves the glottic view during laryngoscopy but remains a difficult procedure"],"prefix":"10.1177","volume":"48","author":[{"given":"Tao","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital), Wuhu, China"},{"name":"Research Center for Functional Maintenance and Reconstruction of Viscera, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital) Wuhu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong-rong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Education, the First Affiliated Hospital, Yijishan Hospital of Wannan Medical College, Wuhu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Longhini","sequence":"additional","affiliation":[{"name":"Anesthesia and Intensive Care, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital)Wuhu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-fang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital)Wuhu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang-fang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital)Wuhu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fu-zhou","family":"Hua","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, the Second Affiliated Hospital of Nanchang University, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0429-4053","authenticated-orcid":false,"given":"Wei-dong","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital)Wuhu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-ju","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital)Wuhu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,5,27]]},"reference":[{"key":"bibr1-0300060520925325","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60806-6"},{"key":"bibr2-0300060520925325","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aex051"},{"key":"bibr3-0300060520925325","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000001528"},{"key":"bibr4-0300060520925325","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/61.2.211"},{"key":"bibr5-0300060520925325","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199702000-00033"},{"key":"bibr6-0300060520925325","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200403000-00020"},{"key":"bibr7-0300060520925325","doi-asserted-by":"publisher","DOI":"10.1007\/BF03037041"},{"key":"bibr8-0300060520925325","doi-asserted-by":"publisher","DOI":"10.1007\/BF03011357"},{"key":"bibr9-0300060520925325","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1987.tb04039.x"},{"key":"bibr10-0300060520925325","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e3181af7f0d"},{"key":"bibr11-0300060520925325","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1984.tb08932.x"},{"key":"bibr12-0300060520925325","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31827773b2"},{"key":"bibr13-0300060520925325","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aev371"},{"key":"bibr14-0300060520925325","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.21413"},{"key":"bibr15-0300060520925325","doi-asserted-by":"publisher","DOI":"10.1007\/s001010050521"},{"key":"bibr16-0300060520925325","doi-asserted-by":"publisher","DOI":"10.1007\/BF03013910"},{"key":"bibr17-0300060520925325","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/80.2.140"},{"key":"bibr18-0300060520925325","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000196507.19771.b2"}],"container-title":["Journal 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