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Anesthesiology Jan 2022The American Society of Anesthesiologists; All India Difficult Airway Association; European Airway Management Society; European Society of Anaesthesiology and Intensive... (Review)
Review
The American Society of Anesthesiologists; All India Difficult Airway Association; European Airway Management Society; European Society of Anaesthesiology and Intensive Care; Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care; Learning, Teaching and Investigation Difficult Airway Group; Society for Airway Management; Society for Ambulatory Anesthesia; Society for Head and Neck Anesthesia; Society for Pediatric Anesthesia; Society of Critical Care Anesthesiologists; and the Trauma Anesthesiology Society present an updated report of the Practice Guidelines for Management of the Difficult Airway.
Topics: Airway Management; Anesthesiologists; Humans; Intubation, Intratracheal; Practice Guidelines as Topic; Societies, Medical; United States
PubMed: 34762729
DOI: 10.1097/ALN.0000000000004002 -
Minerva Anestesiologica Mar 2018Supraglottic airway devices (SADs) have become an essential tool in airway management. Over the past three decades, these devices have been increasingly adopted as an... (Review)
Review
Supraglottic airway devices (SADs) have become an essential tool in airway management. Over the past three decades, these devices have been increasingly adopted as an alternative to face mask ventilation and/or endotracheal intubation. The range of proposed uses and features has increased significantly. They are used in pre- and in-hospital settings, elective and emergency anesthesia, in spontaneously breathing and ventilated patients, as conduits for intubation, as a bridge to extubation and for airway rescue. With SADs, serious complications such as aspiration and loss of airway are rare and largely preventable. Adequate operator experience, familiarity with the selected device, attention to details and careful patient selection are fundamental to safety and proficiency. In this review, we explore the increasing proposed uses for SADs and discuss possible complications and the management of these.
Topics: Airway Management; Contraindications; Epiglottis; Humans; Intubation, Intratracheal; Resuscitation
PubMed: 29027772
DOI: 10.23736/S0375-9393.17.12112-7 -
Anaesthesia Jul 2020We reviewed the literature on management of general and regional anaesthesia in pregnant women with anticipated airway difficulty. We identified 138 publications... (Review)
Review
We reviewed the literature on management of general and regional anaesthesia in pregnant women with anticipated airway difficulty. We identified 138 publications comprising 158 cases; these either described equipment or techniques for the provision of general anaesthesia, or the management of women with regional analgesia or anaesthesia, with the aim of avoiding general anaesthesia. Most of the former group described women requiring caesarean section alone, or in combination with other surgery, which was sometimes airway-related. Management techniques were largely similar to those in non-obstetric patients requiring surgery who have airway difficulties, although suggested differences related to physiological changes of pregnancy and avoidance of nasal intubation. In the reports discussing regional anaesthesia, consideration was often given to the possible requirement for urgent out-of-hours anaesthetic intervention, and the predicted difficulty of management of general anaesthesia should it be required. In a number of reported cases, multidisciplinary planning led to the conclusion that elective caesarean section should be performed in order to avoid emergency airway management. Based on this literature review, we advise antenatal planning that includes: assessment of the patient's clinical characteristics; consideration of the equipment and personnel available to provide safe airway management out-of-hours; and elective caesarean section should these be lacking. If general anaesthesia is required, a risk assessment must be made as to the probability of safe airway management after the induction of anaesthesia, and awake tracheal intubation should be used if this cannot be assured. Decision aids are provided to illustrate these points. Online appendices include a comprehensive compendium of case reports on the management of a number of rare syndromes and airway conditions.
Topics: Airway Management; Analgesia, Epidural; Analgesia, Obstetrical; Anesthesia, General; Anesthesia, Obstetrical; Cesarean Section; Female; Humans; Intubation, Intratracheal; Pregnancy; Tracheostomy
PubMed: 32144770
DOI: 10.1111/anae.15007 -
Acta Clinica Croatica Apr 2023Neurosurgical patients have specific airway management. Various conditions and diagnoses make intubation difficult and may also cause neurological damage. Spinal... (Review)
Review
Neurosurgical patients have specific airway management. Various conditions and diagnoses make intubation difficult and may also cause neurological damage. Spinal pathology, neurotrauma, cervical spine surgery, and pituitary gland surgery are just some examples. The aim of this review article is to present a broad spectrum of neurosurgical operations and potential complications in maintaining airway patency related to these issues. Quality perioperative preparation is a prerequisite to avoid the potentially irreversible consequences of difficult airways with a poor neurological or even fatal outcome. Patients with tumors of the pituitary region who present with Cushing's disease are prone to difficult ventilation, tracheal obstruction and difficult intubation. Awake craniotomy is also a challenge for the anesthesiologist, given that access to the airway is problematic due to the fixed frame. Unstable cervical spine occurs in cases of rheumatoid arthritis or blunt trauma, requiring precautions to be taken with spinal stabilization during intubation and induction. Pharyngeal edema and hematomas, possible complications of cervical spine surgery can endanger airway patency after extubation; postoperative patient supervision is thus required. Due to the potential threat to the patient's airway during neurosurgical procedures, quality anesthetic preoperative preparation is necessary to avoid irreversible damage and death.
Topics: Humans; Airway Management; Neurosurgical Procedures; Anesthesia; Intubation, Intratracheal; Neuroanesthesia
PubMed: 38746598
DOI: 10.20471/acc.2023.62.s1.15 -
Anaesthesia Jul 2015
Topics: Equipment Design; Intubation, Intratracheal
PubMed: 26580250
DOI: 10.1111/anae.13110 -
International Journal of Molecular... Jan 2016Inhalation studies are the gold standard for the estimation of the harmful effects of respirable chemical substances, while there is limited evidence of the harmful... (Review)
Review
Inhalation studies are the gold standard for the estimation of the harmful effects of respirable chemical substances, while there is limited evidence of the harmful effects of chemical substances by intratracheal instillation. We reviewed the effectiveness of intratracheal instillation studies for estimating the hazards of nanoparticles, mainly using papers in which both inhalation and intratracheal instillation studies were performed using the same nanoparticles. Compared to inhalation studies, there is a tendency in intratracheal instillation studies that pulmonary inflammation lasted longer in the lungs. A difference in pulmonary inflammation between high and low toxicity nanoparticles was observed in the intratracheal instillation studies, as in the inhalation studies. Among the endpoints of pulmonary toxicity, the kinetics of neutrophil counts, percentage of neutrophils, and chemokines for neutrophils and macrophages, heme oxygenase-1 (HO-1) in bronchoalveolar lavage fluid (BALF), reflected pulmonary inflammation, suggesting that these markers may be considered the predictive markers of pulmonary toxicity in both types of study. When comparing pulmonary inflammation between intratracheal instillation and inhalation studies under the same initial lung burden, there is a tendency that the inflammatory response following the intratracheal instillation of nanoparticles is greater than or equal to that following the inhalation of nanoparticles. If the difference in clearance in both studies is not large, the estimations of pulmonary toxicity are close. We suggest that intratracheal instillation studies can be useful for ranking the hazard of nanoparticles through pulmonary inflammation.
Topics: Administration, Mucosal; Animals; Biomarkers; Humans; Instillation, Drug; Nanoparticles; Pneumonia; Respiratory Mucosa; Trachea
PubMed: 26828483
DOI: 10.3390/ijms17020165 -
Critical Care (London, England) Oct 2018
Topics: Capsule Endoscopy; Emergency Medical Services; Humans; Intubation, Intratracheal
PubMed: 30290845
DOI: 10.1186/s13054-018-2184-9 -
Academic Emergency Medicine : Official... Feb 2016
Topics: Checklist; Emergency Service, Hospital; Female; Humans; Intubation, Intratracheal; Male
PubMed: 26763737
DOI: 10.1111/acem.12868 -
Anesthesiology Jul 2019
Topics: Abdomen; Humans; Intubation, Intratracheal; Oropharynx; Scleroderma, Systemic
PubMed: 30829660
DOI: 10.1097/ALN.0000000000002658 -
Anesthesia and Analgesia May 2020
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Humans; Infection Control; Infectious Disease Transmission, Patient-to-Professional; Intubation, Intratracheal; Pandemics; Pneumonia, Viral; Practice Guidelines as Topic; SARS-CoV-2
PubMed: 32209810
DOI: 10.1213/ANE.0000000000004803