Xia Ming, Ma Wuhua, Zuo Mingzhang, Deng Xiaoming, Xue Fushan, Battaglini Denise, Aggarwal Vivek, Varrassi Giustino, Cerny Vladimir, Di Giacinto Ida, Cataldo Rita, Ma Daqing, Yamamoto Toru, Rekatsina Martina, De Cassai Alessandro, Carsetti Andrea, Chang Marvin G, Seet Edwin, Davis Daniel P, Irwin Michael G, Huang Yuguang, Jiang Hong
Department of Anesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.
Hepatobiliary Surg Nutr. 2023 Aug 1;12(4):545-566. doi: 10.21037/hbsn-23-46. Epub 2023 May 19.
Identifying a potentially difficult airway is crucial both in anaesthesia in the operating room (OR) and non-operation room sites. There are no guidelines or expert consensus focused on the assessment of the difficult airway before, so this expert consensus is developed to provide guidance for airway assessment, making this process more standardized and accurate to reduce airway-related complications and improve safety.
Seven members from the Airway Management Group of the Chinese Society of Anaesthesiology (CSA) met to discuss the first draft and then this was sent to 15 international experts for review, comment, and approval. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) is used to determine the level of evidence and grade the strength of recommendations. The recommendations were revised through a three-round Delphi survey from experts.
This expert consensus provides a comprehensive approach to airway assessment based on the medical history, physical examination, comprehensive scores, imaging, and new developments including transnasal endoscopy, virtual laryngoscopy, and 3D printing. In addition, this consensus also reviews some new technologies currently under development such as prediction from facial images and voice information with the aim of proposing new research directions for the assessment of difficult airway.
This consensus applies to anesthesiologists, critical care, and emergency physicians refining the preoperative airway assessment and preparing an appropriate intubation strategy for patients with a potentially difficult airway.
识别潜在的困难气道在手术室（OR）麻醉和非手术室场所中都至关重要。此前尚无专注于困难气道评估的指南或专家共识，因此制定本专家共识以提供气道评估指导，使该过程更规范、准确，减少气道相关并发症并提高安全性。
中华医学会麻醉学分会（CSA）气道管理组的七名成员开会讨论初稿，然后将其发送给15名国际专家进行审阅、评论和批准。采用推荐分级、评估、制定与评价（GRADE）方法来确定证据水平并对推荐强度进行分级。通过三轮专家德尔菲调查对推荐意见进行修订。
本专家共识提供了一种基于病史、体格检查、综合评分、影像学以及包括经鼻内镜检查、虚拟喉镜检查和3D打印在内的新进展的气道评估综合方法。此外，本共识还回顾了一些目前正在研发的新技术，如通过面部图像和语音信息进行预测，旨在为困难气道评估提出新的研究方向。
本共识适用于麻醉医师、重症监护医师和急诊医师，以完善术前气道评估并为有潜在困难气道的患者制定合适的插管策略。
