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Colombian Journal of Anestesiology
Print version ISSN 0120-3347
Abstract
ARTEAGA, Iván Mauricio. Update on difficult airway management with a proposal of a simplified algorithm, unified and applied to our daily clinical practice. Rev. colomb. anestesiol. [online]. 2018, vol.46, n.1, pp.55-64. ISSN 0120-3347. https://doi.org/10.1097/cj9.0000000000000010.
Introduction:
Difficulties in managing the airway are still a major cause of morbidity, mortality, and anesthesia and critical care related claims.
Objectives:
Review the current trends and the recent evidence associated with management of the difficult airway to organize them into a simple, practical, and unified scheme.
Methods:
Non-systematic search in PubMed, ScienceDirect, OVID, and SciELO, using the terms: airway management, airway emergency, difficult laryngoscopy, difficult intubation, difficult mask ventilation, and difficult ventilation. Evidence-based guidelines and expert consensus were prioritized.
Results:
Twenty-nine guidelines and expert consensus were found, of which 19 were published after 2004, 10 addressed to the general population, 3 to obstetrics, 4 to pediatrics, and 2 to trauma.
Conclusions:
In terms of critical airway situations, there is purely observational evidence of actual situations or moderate-quality evidence under parallel situations. When evaluating risk, in addition to identifying predictors, it is important to consider the clinical circumstances that may worsen any potential problem. The newly developed techniques and devices are useful tools, but skills in conventional maneuvers and their optimization are irreplaceable. In addition to focusing on maneuvering to solve intubation or ventilation issues, the resuscitation practitioner must watch over the patient's general clinical condition and the potential causes of the problem. A simple and well supported thought process could facilitate the management of complex situations and improved outcomes.
Keywords : Airway Management; Intubation; Intratracheal; Ventilation; Tracheostomy; Anesthesia.