围手术期气道管理的多学科国际专家共识
Multidisciplinary international expert consensus on perioperative airway management.
作者信息
Liang Hengrui, Che Guowei, Cui Fei, Dong Junguo, Gu Weiquan, Gu Chundong, Xu Shun, Ba Yufeng, Cai Kaican, Cao Qingdong, Chen Chang, Chen Chun, Chen Qixun, Cheng Liyang, Feng Gang, Gou Yunjiu, Guo Wenwei, He Jinxi, He Junming, Hu Jian, Huang Ying, Wang Wenxi, Jiao Wenjie, Jiang Shunjun, Liu Jun, Lan Lan, Li Wei, Li Xiaofei, Li Zhongcheng, Li Yin, Liang Zhu, Liu Hongxu, Liu Yingbin, Mei Xinyu, Song Xicheng, Sun Daqiang, Tian Hui, Tian Ziqiang, Wang Jianhua, Wang Guangsuo, Xu Xin, Xiang Xudong, Xu Guobing, Xue Tao, Yang Chao, Yan Xiaolong, Yang Nuo, Yao Feng, Yin Dalong, Yin Xiaochuan, Yu Bentong, Zhai Wei, Zhang Yu, Zhang Guangjian, Zhang Xiaowen, Zhang Qiang, Zhang Yi, Zhao Jun, Zhong Haihui, Brunelli Alessandro, Ploenes Till, Bertolaccini Luca, Tam John Kit Chung, Kim Min P, Refai Majed, Gonzalez Michel, Dyas Adam R, Ardò Nicoletta Pia, Fernando Hiran C, Maurizi Giulio, Kocher Gregor J, Marulli Giuseppe, Fuentes-Martín Álvaro, Perroni Gianluca, Kim Kyung Soo, Rodriguez Maria, Taylor Marcus, Zou Xusen, Wang Wei, He Jianxing
机构信息
Department of Thoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China.
出版信息
Transl Lung Cancer Res. 2025 Apr 30;14(4):1042-1060. doi: 10.21037/tlcr-2025-273. Epub 2025 Apr 16.
BACKGROUND
Perioperative airway management is critical for patient safety and optimal surgical outcomes. Effective airway management reduces postoperative pulmonary complications and accelerates recovery. This expert consensus aims to update the earlier consensus based on the latest research and emphasize aspects that were previously overlooked.
METHODS
A comprehensive search up to June 2024 was performed. Earlier consensus documents were reviewed to ensure thorough coverage. A modified Delphi method involved 62 domestic experts from various surgical and anesthetic specialties who discussed and voted on preliminary recommendations in face-to-face meetings, requiring ≥70% agreement. Drafts were then reviewed by 18 international experts via email to incorporate diverse insights.
RESULTS
Through the modified Delphi method, consensus was achieved with ≥70% agreement among the 62 domestic experts, ensuring that the preliminary recommendations were robust and widely supported. Additionally, feedback from the 18 international experts provided diverse insights that further refined and validated the recommendations. Recommendations were established for preoperative airway preparation, anesthesia management, surgical approach, postoperative airway management, and managing coexisting respiratory diseases. These recommendations update the perspectives of earlier consensus documents based on the latest research and emphasize non-intubated surgery, inhalation therapy, and individualized treatment for patients with coexisting pulmonary diseases.
CONCLUSIONS
This expert consensus provides a valuable reference for clinical practice. Further technological optimization and clinical research are needed to improve perioperative airway management.
背景
围手术期气道管理对于患者安全和最佳手术结局至关重要。有效的气道管理可减少术后肺部并发症并加速康复。本专家共识旨在根据最新研究更新早期共识，并强调先前被忽视的方面。
方法
进行了截至2024年6月的全面检索。对早期共识文件进行了审查以确保全面覆盖。一种改良的德尔菲法涉及来自各个外科和麻醉专科的62位国内专家，他们在面对面会议上对初步建议进行了讨论和投票，要求达成≥70%的共识。然后由18位国际专家通过电子邮件对草案进行审查，以纳入不同的见解。
结果
通过改良的德尔菲法，62位国内专家达成了≥70%的共识，确保初步建议具有充分依据且得到广泛支持。此外，18位国际专家的反馈提供了不同的见解，进一步完善和验证了这些建议。针对术前气道准备、麻醉管理、手术方式、术后气道管理以及合并呼吸系统疾病的管理制定了建议。这些建议基于最新研究更新了早期共识文件的观点，并强调了非插管手术、吸入治疗以及合并肺部疾病患者的个体化治疗。
结论
本专家共识为临床实践提供了有价值的参考。需要进一步的技术优化和临床研究以改善围手术期气道管理。
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