Schecter W P, Wilson R S
Crit Care Med. 1981 Aug;9(8):577-9. doi: 10.1097/00003246-198108000-00004.
Three patients under observation in ICUs developed mechanical upper airway obstruction requiring surgical intervention for airway control. One patient was treated by tracheotomy placed through a vertical midline incision and 2 patients were treated by cricothyroidotomy followed by elective tracheostomy and closure of the cricothyroidotomy. The literature of acute upper airway obstruction is reviewed and recommendations made for rapid assessment and management of these patients. The importance of rapid cricothyroidotomy through a small incision in patients unresponsive to less invasive measures is emphasized. The use of a small pediatric endotracheal tube placed through the cricothyroidotomy incision is suggested as a method to increase the speed and safety of the procedure and avoid the potential long-term complication of laryngeal stricture.
重症监护病房（ICU）中正在接受观察的3例患者发生了机械性上气道梗阻，需要进行手术干预以控制气道。1例患者通过垂直中线切口行气管切开术治疗，2例患者先行环甲膜切开术，随后择期行气管造口术并关闭环甲膜切开处。本文回顾了急性上气道梗阻的相关文献，并对这些患者的快速评估和处理提出了建议。强调了对于对侵入性较小的措施无反应的患者，通过小切口快速行环甲膜切开术的重要性。建议通过环甲膜切开处切口置入小儿气管内插管，作为一种提高手术速度和安全性并避免喉狭窄潜在长期并发症的方法。
