Gerheuser F, Gürtler K
Klinik für Anästhesiologie und Operative Intensivmedizin, Klinikum Augsburg, Deutschland.
Anaesthesist. 2011 Dec;60(12):1157-74; quiz 1175-7. doi: 10.1007/s00101-011-1963-3.
Airway management is a core task for anesthesiologists. Deficiencies in training or equipment as well as fateful complications in this field are responsible for a significant proportion of anesthesia-associated morbidity and mortality. Nowadays there are a variety of advanced technical aids on the market to overcome the difficult airway. Nevertheless, the "cannot intubate cannot ventilate scenario" still occurs and regularly results in poor outcome, such as permanent neurological deficits or even death. Therefore, awake fiberoptic intubation remains the gold standard in the expected difficult airway because when applied correctly this technique never leads to a point where a patient's respiration is compromised as a result of medical measures before a secure airway has been established.
气道管理是麻醉医生的核心任务。培训或设备方面的不足以及该领域的致命并发症在很大一部分麻醉相关的发病率和死亡率中负有责任。如今市场上有多种先进的技术辅助工具来应对困难气道。然而,“无法插管无法通气的情况”仍然会出现,并经常导致不良后果,如永久性神经功能缺损甚至死亡。因此,清醒纤维支气管镜插管仍然是预期困难气道的金标准,因为如果正确应用,该技术在建立安全气道之前绝不会导致因医疗措施而使患者呼吸受到损害的情况。