medigraphic.com
ISSN 0001-0944 (Print)
Órgano Oficial de la Asociación Dental Mexicana

2022, Number 5

<< Back Next >>

Rev ADM 2022; 79 (5)

Difficult airway management in emergency intubation, systemic review and meta-analysis.

Gutiérrez HLA, Morales PA

Language: Spanish
References: 24
Page: 271-275
PDF size: 208.41 Kb.


ABSTRACT

Introduction: difficult airway is that clinical situation in which a conventionally trained anesthesiologist experiences difficulty in ventilation with a face mask, in endotracheal intubation or both. In this review article we will focus on emergency intubation. Objective: to systematically review the current state of knowledge and clinical evidence related to the management of difficult airways in emergency intubation. Material and methods: a systematic review was carried out in PubMed, Cochrane data base, EBSCO and OVID; the terms: difficult airway management and emergency intubation; only clinical trials and scientific research reports were analyzed. Results: the search yielded 356 results, of which systematic review studies, meta-analysis, opinion-based articles, case reports, letters to the editor were excluded; which gave us 128 articles, after they were analyzed; it was also sought to analyze articles from different areas of medical research; 21 articles were selected to be analyzed in this systematic review. Conclusions: unexpectedly, the majority of the reviewed articles conclude that regardless of the intubation protocol or the tools used, the aspect that plays a decisive role in the management of the difficult airway is the experience and previous preparation of the anesthesiologist.


REFERENCES

  1. Coloma R, Álvarez JP. Manejo avanzado de la vía aérea. Revista Médica Clínica Las Condes. 2011; 22 (3): 270-279.

  2. Auroy Y, Benhamou D, Péquignot F, Bovet M, Jougla E, Lienhart A. Mortality related to anaesthesia in France: analysis of deaths related to airway complications. Anaesthesia. 2009; 64 (4): 366-370.

  3. Cook TM, Woodall N, Frerk C; Fourth National Audit Project. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br J Anaesth. 2011; 106 (5): 617-631.

  4. Galván-Talamantes Y, Espinoza de los Monteros-Estrada I. Manejo de vía aérea difícil. Rev Mex Anest. 2013; 36 (Suppl: 1): 312-315.

  5. Yu JH, Wang Y. Clinical study of SMT-II video laryngoscope with difficult airway intubation in emergency department. Zhonghua Wai Ke Za Zhi. 2017; 55 (7): 549-553. doi: 10.3760/cma.j.issn.0529-5815.2017.07.014.

  6. Ahmadi K, Ebrahimi M, Hashemian AM, Sarshar S, Rahimi-Movaghar V. GlideScope video laryngoscope for difficult intubation in emergency patients: a quasi-randomized controlled trial. Acta Med Iran. 2015; 53 (12): 738-742.

  7. Kulnig J, Füreder L, Harrison N, Frass M, Robak O. Performance and skill retention of five supraglottic airway devices for the pediatric difficult airway in a manikin. Eur J Pediatr. 2018; 177 (6): 871-878.

  8. Liu L, Tanigawa K, Kusunoki S, Tamura T, Ota K, Yamaga S et al. Tracheal intubation of a difficult airway using Airway Scope, Airtraq, and Macintosh laryngoscope: a comparative manikin study of inexperienced personnel. Anesth Analg. 2010; 110 (4): 1049-1055.

  9. Plazikowski E, Greif R, Marschall J, Pedersen TH, Kleine-Brueggeney M, Albrecht R et al. Emergency airway management in a simulation of highly contagious isolated patients: both isolation strategy and device type matter. Infect Control Hosp Epidemiol. 2018; 39 (2): 145-151.

  10. Staudinger T, Tesinsky P, Klappacher G, Brugger S, Rintelen C, Locker G, et al. Emergency intubation with the Combitube in two cases of difficult airway management. Eur J Anaesthesiol. 1995; 12 (2): 189-193.

  11. Driver BE, Prekker ME, Klein LR, Reardon RF, Miner JR, Fagerstrom ET et al. Effect of use of a bougie vs endotracheal tube and stylet on first-attempt intubation success among patients with difficult airways undergoing emergency intubation: a randomized clinical trial. JAMA. 2018; 319 (21): 2179-2189.

  12. Ambrosio A, Pfannenstiel T, Bach K, Cornelissen C, Gaconnet C, Brigger MT. Difficult airway management for novice physicians: a randomized trial comparing direct and video-assisted laryngoscopy. Otolaryngol Head Neck Surg. 2014; 150 (5): 775-778.

  13. Ollerton JE, Parr MJ, Harrison K, Hanrahan B, Sugrue M. Potential cervical spine injury and difficult airway management for emergency intubation of trauma adults in the emergency department--a systematic review. Emerg Med J. 2006; 23 (1): 3-11.

  14. Hubert V, Duwat A, Deransy R, Mahjoub Y, Dupont H. Effect of simulation training on compliance with difficult airway management algorithms, technical ability, and skills retention for emergency cricothyrotomy. Anesthesiology. 2014; 120 (4): 999-1008.

  15. Kurola J, Harve H, Kettunen T, Laakso JP, Gorski J, Paakkonen H et al. Airway management in cardiac arrest--comparison of the laryngeal tube, tracheal intubation and bag-valve mask ventilation in emergency medical training. Resuscitation. 2004; 61 (2): 149-153.

  16. Cattano D, Killoran PV, Iannucci D, Maddukuri V, Altamirano AV, Sridhar S et al. Anticipation of the difficult airway: preoperative airway assessment, an educational and quality improvement tool. Br J Anaesth. 2013; 111 (2): 276-285.

  17. Phillips S, Celenza A. Comparison of the Pentax AWS videolaryngoscope with the Macintosh laryngoscope in simulated difficult airway intubations by emergency physicians. Am J Emerg Med. 2011; 29 (8): 863-867.

  18. Hafner JW, Perkins BW, Korosac JD, Bucher AK, Aldag JC, Cox KL. Intubation performance of advanced airway devices in a helicopter emergency medical service setting. Air Med J. 2016; 35 (3): 132-137.

  19. Hung TY, Lin LW, Yeh YH, Su YC, Lin CH, Yang TF. The evaluation of a better intubation strategy when only the epiglottis is visible: a randomized, cross-over mannequin study. BMC Anesthesiol. 2019; 19 (1): 8.

  20. Hilton MT, Carlson JN, Chan S, Phrampus PE. Impact of stylet use in a simulated difficult airway model. Am J Emerg Med. 2013; 31 (3): 578-580.

  21. Schumacher J, Arlidge J, Dudley D, Sicinski M, Ahmad I. The impact of respiratory protective equipment on difficult airway management: a randomised, crossover, simulation study. Anaesthesia. 2020; 75 (10): 1301-1306.

  22. Komatsu R, Kamata K, Hamada K, Sessler DI, Ozaki M. Airway scope and StyletScope for tracheal intubation in a simulated difficult airway. Anesth Analg. 2009; 108 (1): 273-279.

  23. Fong S, Li E, Violato E, Reid A, Gu Y. Impact of aerosol box on intubation during COVID-19: a simulation study of normal and difficult airways. Can J Anaesth. 2021; 68 (4): 496-504.

  24. Weiss M, Schwarz U, Gerber AC. Difficult airway management: comparison of the Bullard laryngoscope with the video-optical intubation stylet. Can J Anaesth. 2000; 47 (3): 280-284.




2020     |     www.medigraphic.com