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困难气道管理的创新:一篇叙述性综述

Innovations in the Management of the Difficult Airway: A Narrative Review.

作者信息

Ravindran Binu

机构信息

Anaesthesiology, Dartford and Gravesham NHS Trust, Dartford, GBR.

出版信息

Cureus. 2023 Feb 17;15(2):e35117. doi: 10.7759/cureus.35117. eCollection 2023 Feb.

Abstract

The difficult airway (DA) remains a perpetual challenge and its implications have led to multiple advances, technological and otherwise in this area. This article investigates the latest developments in the definition, prediction tools and diagnostics like airway and neck Ultrasonography (USG), Magnetic Resonance Imaging (MRI) and Computed tomography (CT) scans, preoperative Virtual endoscopy (VE) and 3D printing. Innovations in airway devices and adjuncts are analysed. Difficult airway society (DAS) guidelines, American Society of Anaesthesiologists (ASA) Practice Guidelines and Vortex approach for the management of DA are explored. Other breakthroughs include novel oxygen supplementation techniques throughout airway management and tools like Anaesthesia Information Management Systems (AIMS) and Clinical Decision Support (CDS) systems. The delivery of DA training and patient counselling has also undergone vast changes with emerging technology like Virtual Reality (VR), mobile applications and toolkits. The enormous, ever-evolving and endless possibilities in this area have only helped improve clinical standards and enhance patient safety.

摘要

困难气道仍然是一个长期存在的挑战,其影响促使该领域在技术及其他方面取得了多项进展。本文探讨了在定义、预测工具以及诊断方法(如气道和颈部超声检查(USG)、磁共振成像(MRI)和计算机断层扫描(CT))、术前虚拟内镜检查(VE)和3D打印等方面的最新进展。分析了气道设备及辅助工具的创新情况。探讨了困难气道协会(DAS)指南、美国麻醉医师协会(ASA)实践指南以及处理困难气道的Vortex方法。其他突破包括在整个气道管理过程中的新型氧疗技术,以及诸如麻醉信息管理系统(AIMS)和临床决策支持(CDS)系统等工具。随着虚拟现实(VR)、移动应用程序和工具包等新兴技术的出现,困难气道培训和患者咨询的开展方式也发生了巨大变化。该领域巨大、不断发展且无穷无尽的可能性,仅有助于提高临床标准并增强患者安全。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a96/10024956/c38ce52964cd/cureus-0015-00000035117-i01.jpg

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