Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University Irving Medical Center, New York, New York.
Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
Respir Care. 2023 Oct;68(10):1438-1448. doi: 10.4187/respcare.10821. Epub 2023 May 23.
Endotracheal intubation for airway management is a common procedure in the ICU. Intubation may be difficult due to anatomic airway abnormalities but also due to physiologic derangements that predispose patients to cardiovascular collapse during the procedure. Results of studies demonstrate a high incidence of morbidity and mortality associated with airway management in the ICU. To reduce the likelihood of complications, medical teams must be well versed in the general principles of intubation and be prepared to manage physiologic derangements while securing the airway. In this review, we present relevant literature on the approach to endotracheal intubation in the ICU and provide pragmatic recommendations relevant to medical teams performing intubations in patients who are physiologically unstable.
经口气管插管术用于 ICU 的气道管理是一种常见的操作。由于解剖学气道异常，插管可能会很困难，但也可能由于生理紊乱，使患者在操作过程中容易发生心血管崩溃。研究结果表明，与 ICU 中的气道管理相关的发病率和死亡率很高。为了降低并发症的可能性，医疗团队必须精通插管的一般原则，并准备好在确保气道通畅的同时，处理生理紊乱。在这篇综述中，我们介绍了 ICU 中经口气管插管的相关文献，并为生理不稳定的患者进行插管的医疗团队提供了相关的实用建议。
