Nagler Joshua, Bachur Richard G
Division of Emergency Medicine, Children's Hospital Boston, Boston, MA 02115, USA.
Curr Opin Pediatr. 2009 Jun;21(3):299-305. doi: 10.1097/MOP.0b013e32832b112c.
Advanced airway management in children can be challenging, and the potential for morbidity following failed attempts is high.
Supraglottic rescue devices, including the laryngeal mask airway, esophageal-tracheal combination tube, and laryngeal tube have been shown to be suitable ventilation strategies following failed intubation and in arrest scenarios. In addition, a newly developed reversal agent for rocuronium is being investigated as a means of limiting the duration of neuromuscular blockade following rapid sequence induction. Finally, the advent of video laryngoscopy has been shown to have advantages over traditional direct laryngoscopy, in terms of both patient care and training.
Pediatric providers are encouraged to develop familiarity with emerging rescue ventilation devices, as well as recent advances in the practice of rapid sequence induction and laryngoscopy.
儿童高级气道管理具有挑战性,插管失败后发生并发症的可能性很高。
声门上急救设备,包括喉罩气道、食管气管联合导管和喉管,已被证明是插管失败和心脏骤停情况下合适的通气策略。此外,一种新开发的罗库溴铵逆转剂正在进行研究,作为限制快速顺序诱导后神经肌肉阻滞持续时间的一种手段。最后,视频喉镜的出现已被证明在患者护理和培训方面比传统直接喉镜具有优势。
鼓励儿科医护人员熟悉新兴的急救通气设备,以及快速顺序诱导和喉镜检查实践中的最新进展。