Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 5.020, Houston, TX 77030, USA.
Anesthesiology, Critical Care & Pain Medicine, Department of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, 1400 Holcombe Boulevard, Unit 409, Houston, TX 77030, USA.
Anesthesiol Clin. 2020 Dec;38(4):875-888. doi: 10.1016/j.anclin.2020.08.012.
Management of the unanticipated difficult airway is one of the most relevant and challenging crisis management scenarios encountered in clinical anesthesia practice. Several guidelines and approaches have been developed to assist clinicians in navigating this high-acuity scenario. In the most serious cases, the clinician may encounter a failed airway that results from failure to ventilate an anesthetized patient via facemask or supraglottic airway or intubate the patient with an endotracheal tube. This dreaded cannot intubate, cannot oxygenate situation necessitates emergency invasive access. This article reviews the incidence, management, and complications of the failed airway and training issues related to its management.
处理意料之外的困难气道是临床麻醉实践中最相关和最具挑战性的危机管理情况之一。已经制定了一些指南和方法来帮助临床医生应对这种高难度的情况。在最严重的情况下,临床医生可能会遇到无法通过面罩或声门上气道对麻醉患者进行通气或通过气管内导管对患者进行插管的失败气道。这种可怕的无法插管、无法给氧的情况需要紧急进行有创介入。本文回顾了失败气道的发生率、处理方法和并发症,以及与之相关的处理培训问题。