Myatra Sheila Nainan, Dhawan Ira, D'Souza Shirley Ann, Elakkumanan Lenin Babu, Jain Divya, Natarajan Pratheeba
Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India.
Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Indian J Anaesth. 2023 Jan;67(1):48-55. doi: 10.4103/ija.ija_26_23. Epub 2023 Jan 21.
Airway management is a core skill essential for anaesthesiologists and health care providers involved in resuscitation and acute care of patients. Advancements in airway management are continuously evolving. This narrative review highlights the recent advancements with respect to innovations, tools, techniques, guidelines, and research in both technical and non-technical aspects of airway management. These include nasal endoscopy, virtual endoscopy, airway ultrasound, video endoscopes, supraglottic airways with enhanced protection against aspiration, hybrid devices, and the use of artificial intelligence and telemedicine, the utility of which has increased in recent times, thereby improving success with airway management and enhancing patient safety. There has been an increasing emphasis on peri-intubation oxygenation strategies to reduce complications in patients with a physiologically difficult airway. Recent guidelines for difficult airway management and preventing unrecognised oesophageal intubation are available. Large multicentre airway data collection helps us examine airway incidents, aetiology, and complications to expand our knowledge and give us insights for change in practice.
气道管理是麻醉医生以及参与患者复苏和急性护理的医疗保健人员所必需的一项核心技能。气道管理的进展一直在不断演变。这篇叙述性综述重点介绍了气道管理在技术和非技术方面的创新、工具、技术、指南及研究的最新进展。这些进展包括鼻内镜检查、虚拟内镜检查、气道超声、视频内镜、具有增强误吸防护功能的声门上气道、混合设备以及人工智能和远程医疗的应用,其效用在最近有所增加,从而提高了气道管理的成功率并增强了患者安全性。人们越来越重视围插管期氧合策略,以减少气道生理条件困难患者的并发症。目前已有关于困难气道管理和预防未识别的食管插管的最新指南。大型多中心气道数据收集有助于我们检查气道事件、病因和并发症,以扩展我们的知识并为实践中的变革提供见解。