Barak Michal, Bahouth Hany, Leiser Yoav, Abu El-Naaj Imad
Department of Anesthesiology, Rambam Health Care Campus, and the Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 31069 Haifa, Israel.
Trauma Center & Emergency Surgery, Department of General Surgery, Rambam Health Care Campus, 31096 Haifa, Israel.
Biomed Res Int. 2015;2015:724032. doi: 10.1155/2015/724032. Epub 2015 Jun 16.
According to the Advanced Trauma Life Support recommendations for managing patients with life-threatening injuries, securing the airway is the first task of a primary caregiver. Airway management of patients with maxillofacial trauma is complex and crucial because it can dictate a patient's survival. Securing the airway of patients with maxillofacial trauma is often extremely difficult because the trauma involves the patient's airway and their breathing is compromised. In these patients, mask ventilation and endotracheal intubation are anticipated to be difficult. Additionally, some of these patients may not yet have been cleared of a cervical spine injury, and all are regarded as having a full stomach and having an increased risk of regurgitation and pulmonary aspiration. The requirements of the intended maxillofacial operation may often preclude the use of an oral intubation tube, and alternative methods for securing the airway should be considered before the start of the surgery. In order to improve the clinical outcome of patients with maxillofacial trauma, cooperation between maxillofacial surgeons, anesthesiologists, and trauma specialists is needed. In this review, we discuss the complexity and difficulties of securing the airway of patients with maxillofacial trauma and present our approach for airway management of such patients.
根据高级创伤生命支持对危及生命损伤患者的处理建议,确保气道安全是首要护理人员的首要任务。颌面创伤患者的气道管理复杂且至关重要,因为它能决定患者的生死。确保颌面创伤患者的气道安全通常极其困难,因为创伤累及患者气道,其呼吸功能受损。在这些患者中,面罩通气和气管插管预计会很困难。此外,其中一些患者可能尚未排除颈椎损伤,所有患者都被视为胃内容物充盈,反流和肺误吸风险增加。预期的颌面手术要求可能常常排除使用口插管,在手术开始前应考虑确保气道安全的替代方法。为了改善颌面创伤患者的临床结局,颌面外科医生、麻醉医生和创伤专家之间需要合作。在本综述中,我们讨论了确保颌面创伤患者气道安全的复杂性和困难,并介绍了我们对此类患者气道管理的方法。