Central Clinical School, Monash University, Melbourne, Vic., Australia.
Cabrini Hospital, Melbourne, Vic., Australia.
Anaesthesia. 2019 Sep;74(9):1175-1185. doi: 10.1111/anae.14779. Epub 2019 Jul 21.
The primary aim of this study was to identify, describe and compare the content of existing difficult airway management algorithms. Secondly, we aimed to describe the literature reporting the implementation of these algorithms. A directed search across three databases (MEDLINE, Embase and Scopus) was performed. All articles were screened for relevance to the research aims and according to pre-determined exclusion criteria. We identified 38 published airway management algorithms. Our results show that most facemask employ a four-step process as represented by a flow chart, with progression from tracheal intubation, facemask ventilation and supraglottic airway device use, to a rescue emergency surgical airway. The identified algorithms are overwhelmingly similar, yet many use differing terminology. The frequency of algorithm publication has increased recently, yet adherence and implementation outcome data remain limited. Our results highlight the lack of a single algorithm that is universally endorsed, recognised and applicable to all difficult airway management situations.
本研究的主要目的是识别、描述和比较现有的困难气道管理算法的内容。其次，我们旨在描述报告这些算法实施情况的文献。我们在三个数据库（MEDLINE、Embase 和 Scopus）中进行了定向搜索。根据预先确定的排除标准，对所有文章进行了相关性筛选。我们确定了 38 种已发表的气道管理算法。研究结果表明，大多数面罩采用流程图表示的四步过程，从气管插管、面罩通气和声门上气道装置使用，进展到紧急抢救性外科气道。确定的算法非常相似，但许多算法使用不同的术语。算法的发表频率最近有所增加，但依从性和实施结果数据仍然有限。研究结果突出表明，缺乏一种普遍得到认可、公认且适用于所有困难气道管理情况的单一算法。
