Airway management in the critically ill.
Journal
Current opinion in critical care
ISSN: 1531-7072
Titre abrégé: Curr Opin Crit Care
Pays: United States
ID NLM: 9504454
Informations de publication
Date de publication:
01 02 2021
01 02 2021
Historique:
pubmed:
19
12
2020
medline:
24
4
2021
entrez:
18
12
2020
Statut:
ppublish
Résumé
To provide an evidence-based approach to improve first pass success in tracheal intubation while maintaining patient safety in the critically ill. Despite advances in the management of critically ill patients, tracheal intubation in these patients remains a high-risk procedure associated with increased morbidity and mortality. Recent interventions to enhance patient safety and improve first pass success in tracheal intubation emphasize reducing repeated attempts at tracheal intubation, oxygen desaturation and cardiovascular collapse during airway management by optimizing patient physiology to mitigate risks and reduce complications. These include various strategies to improve peri-intubation oxygenation like use of noninvasive ventilation, high flow nasal cannula oxygen and gentle mask ventilation between induction of anesthesia and laryngoscopy; use of a videolaryngoscope and a bougie; careful selection of drugs including neuromuscular blocking agent; improved strategies to avoid haemodynamic collapse; rescue oxygenation strategies and human factor considerations. Recognizing the challenges and using the appropriate interventions to improve first pass tracheal intubation success, while maintaining patient safety are essential during tracheal intubation in critically ill patients. This review will provide recommendations based on the current evidence, various guidelines and expert opinion in the field. Further research will help us better understand the best strategies to improve patient outcomes.
Identifiants
pubmed: 33337621
doi: 10.1097/MCC.0000000000000791
pii: 00075198-202102000-00007
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
37-45Informations de copyright
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
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