Natt Bhupinder, Mosier Jarrod
Division of Pulmonary, Allergy, Critical Care, and Sleep, Department of Medicine, University of Arizona College of Medicine, Tucson, AZ USA.
Department of Emergency Medicine, University of Arizona College of Medicine, 1501 N Campbell Ave, AHSL 4171D, PO Box 245057, Tucson, AZ 85724-5057 USA.
Curr Anesthesiol Rep. 2021;11(2):116-127. doi: 10.1007/s40140-021-00448-3. Epub 2021 Apr 19.
This paper will evaluate the recent literature and best practices in airway management in critically ill patients.
Cardiac arrest remains a common complication of intubation in these high-risk patients. Patients with desaturation or peri-intubation hypotension are at high risk of cardiac arrest, and each of these complications have been reported in up to half of all intubations in critically ill patient populations.
There have been significant advances in preoxygenation and devices available for performing laryngoscopy and rescue oxygenation. However, the risk of cardiovascular collapse remains concerningly high with few studies to guide therapeutic maneuvers to reduce this risk.
本文将评估危重症患者气道管理的近期文献及最佳实践。
心脏骤停仍是这些高危患者插管的常见并发症。出现氧饱和度下降或插管期间低血压的患者发生心脏骤停的风险很高,在危重症患者群体的所有插管操作中,高达半数的操作都报告了上述每种并发症。
在预充氧以及用于进行喉镜检查和挽救性给氧的设备方面已取得了重大进展。然而,心血管虚脱的风险仍然高得令人担忧,几乎没有研究可指导降低这种风险的治疗策略。