University of Maryland School of Medicine, Department of Emergency Medicine; Maryland Emergency Medicine Network, Upper Chesapeake Emergency Medicine, 500 Upper Chesapeake Dr, Bel Air, MD 21014, USA.
Emerg Med Clin North Am. 2021 Aug;39(3):493-508. doi: 10.1016/j.emc.2021.04.004. Epub 2021 Jun 10.
Anatomically, the airway is ever changing in size, anteroposterior alignment, and point of most narrow dimension. Special considerations regarding obesity, chronic and acute illness, underlying developmental abnormalities, and age can all affect preparation and intervention toward securing a definitive airway. Mechanical ventilation strategies should focus on limiting peak inspiratory pressures and optimizing lung protective tidal volumes. Emergency physicians should work toward minimizing risk of peri-intubation hypoxemia and arrest. With review of anatomic and physiologic principles in the setting of a practical approach toward evaluating and managing distress and failure, emergency physicians can successfully manage critical pediatric airway encounters.
从解剖学角度来看，气道的大小、前后对齐和最窄维度的位置都在不断变化。肥胖、慢性和急性疾病、潜在的发育异常以及年龄等特殊情况都会影响准备和干预以确保建立明确的气道。机械通气策略应侧重于限制峰值吸气压力和优化肺保护性潮气量。急诊医生应努力降低插管期间低氧血症和骤停的风险。通过审查解剖学和生理学原理，并采用实用方法评估和处理危急和衰竭情况，急诊医生可以成功管理危急儿科气道事件。
