Admass Biruk Adie, Endalew Nigussie Simeneh, Tawye Hailu Yimer, Melesse Debas Yaregal, Workie Misganaw Mengie, Filatie Tesera Dereje
Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Ann Med Surg (Lond). 2022 Aug 4;80:104284. doi: 10.1016/j.amsu.2022.104284. eCollection 2022 Aug.
Airway management outside the theatre is performed either to resuscitate a physiologically unstable critically ill patients or to secure an emergency airway in the absence of essential equipments. It is a life saving procedure for critically ill and injured patients. Delaying in securing airway or awaking the patient is not an option in case of difficult airway in intensive care unit. Therefore, developing and implementation of an evidence-based airway management protocol is important.
This review was conducted to develop a clear airway management protocol for a critical ill patient in medical intensive care unit.
After formulating the key questions, scope, and eligibility criteria for the evidences to be included, a comprehensive search strategy of electronic sources was conducted. The literatures were searched using advanced searching methods from data bases and websites to get evidences on airway management of a critical ill patient. Duplication of literatures was avoided by endnote. Screening of literatures was conducted based on the level of significance with proper appraisal. This review was carried out in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 statement.
A total of 626 articles were identified from data bases and websites using an electronic search. Of these articles, 95 were removed for duplication and 305 studies were excluded after reviewing their titles and abstracts. At the screening stage, 79 articles were retrieved and evaluated for the eligibility. Finally, 40 studies related to airway management of a critical ill patient in medical ICU were included in this systematic review
A critical ill patient needs oxygenation and ventilation support. A focused and rapid assessment, with special attention of the airway and hemodynamic status of the critical ill patient is paramount. An appropriate airway management option should be employed to resuscitate or to control an emergency airway of a critical ill patent. This could be non invasive ventilation or invasive airway intervention.
手术室之外的气道管理，要么是为了抢救生理状态不稳定的重症患者，要么是在缺乏必要设备的情况下确保建立紧急气道。这是一项针对重症和受伤患者的挽救生命的操作。在重症监护病房遇到困难气道时，延迟确保气道安全或唤醒患者都不是可行的选择。因此，制定并实施基于证据的气道管理方案很重要。
本综述旨在为医学重症监护病房的重症患者制定清晰的气道管理方案。
在确定了纳入证据的关键问题、范围和纳入标准后，对电子资源进行了全面的检索策略。使用高级检索方法从数据库和网站搜索文献，以获取有关重症患者气道管理的证据。通过EndNote避免文献重复。根据重要性水平进行适当评估，对文献进行筛选。本综述按照系统评价和Meta分析的首选报告项目（PRISMA）2020声明进行。
通过电子检索从数据库和网站共识别出626篇文章。其中，95篇因重复被剔除，305项研究在查看标题和摘要后被排除。在筛选阶段，检索到79篇文章并评估其是否符合纳入标准。最终，40项与医学重症监护病房重症患者气道管理相关的研究被纳入本系统评价。
重症患者需要氧合和通气支持。进行重点快速评估，特别关注重症患者的气道和血流动力学状态至关重要。应采用适当的气道管理方法来抢救或控制重症患者的紧急气道。这可以是非侵入性通气或侵入性气道干预。
