Hagberg Carin, Georgi Rainer, Krier Claude
Department of Anaesthesiology, University of Texas Medical School at Houston, USA.
Best Pract Res Clin Anaesthesiol. 2005 Dec;19(4):641-59. doi: 10.1016/j.bpa.2005.08.002.
The inability to secure the airway, with consequent failure of oxygenation and ventilation, is a life-threatening complication. Failure of oxygenation leads to hypoxia followed by brain damage, cardiovascular dysfunction, and finally death. Time is a very crucial factor in this context. Complications vary widely in severity; while some are dramatic and immediately life-threatening (unrecognized esophageal intubation), others can be severe and long-lasting (nerve injuries) or mild and short-lived (sore throat). To minimize injury to the patient, the anesthesiologist should examine the patient's airway carefully, identify any potential problems, devise a plan that involves the least risk for injury, and have a back-up plan immediately available. Each anesthesiology department should establish guidelines/algorithms specific to their institution. Unfortunately, a reliable test for detecting all patients at risk does not exist.
无法确保气道安全,进而导致氧合和通气失败,是一种危及生命的并发症。氧合失败会导致缺氧,继而引发脑损伤、心血管功能障碍,最终导致死亡。在这种情况下,时间是一个非常关键的因素。并发症的严重程度差异很大;有些并发症很严重,会立即危及生命(如未识别的食管插管),而另一些则可能很严重且持续时间长(如神经损伤)或轻微且短暂(如喉咙痛)。为了将对患者的伤害降至最低,麻醉医生应仔细检查患者的气道,识别任何潜在问题,制定一个风险最小的损伤计划,并立即准备一个备用计划。每个麻醉科都应制定适用于其机构的指南/算法。不幸的是,不存在一种可靠的检测所有高危患者的方法。