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Airway Management

Airway Management: The critical process of maintaining an unobstructed airway, ensuring adequate ventilation and oxygenation.
This multifaceted field encompasses techniques and devices used to secure, protect, and manage the airway during medical procedures, emergencies, and intensive care.
Effective Airway Management is essential for patient safety and positive clinical outcomes across diverse healthcare settings.
Explore the latest research, protocols, and innovations to optimize Airway Management and take your practice to new heights.

Most cited protocols related to «Airway Management»

1
Difficult Airway Society Guidelines Update
The Difficult Airway Society commissioned a working group to update the guidelines in April 2012. An initial literature search was conducted for the period January 2002 to June 2012 using databases (Medline, PubMed, Embase, and Ovid) and a search engine (Google Scholar). The websites of the American Society of Anesthesiologists (http://www.asahq.org), Australian and New Zealand College of Anaesthetists (http://www.anzca.edu.au), European Society of Anesthesiologists' (http://www.esahq.org/euroanaesthesia), Canadian Anesthesiologists' Society (http://www.cas.ca), and the Scandinavian Society of Anesthesiology and Intensive Care Medicine (http://ssai.info/guidelines/) were also searched for airway guidelines. English language articles and abstract publications were identified using keywords and filters. The search terms were as follows: ‘Aintree intubating catheter’, ‘Airtraq’, ‘airway device’, ‘airway emergency’, ‘airway management’, ‘Ambu aScope’, ‘backward upward rightward pressure’, ‘Bonfils’, ‘Bullard’, ‘bronchoscopy’, ‘BURP manoeuvre’, ‘can't intubate can't ventilate’, ‘can't intubate can't oxygenate’, ‘C-Mac’, ‘Combitube’, ‘cricoid pressure’, ‘cricothyroidotomy’, ‘cricothyrotomy’, ‘C trach’, ‘difficult airway’, ‘difficult intubation’, ‘difficult laryngoscopy’, ‘difficult mask ventilation’, ‘difficult ventilation’, ‘endotracheal intubation’, ‘esophageal intubation’, ‘Eschmann stylet’, ‘failed intubation’, ‘Fastrach’, ‘fiber-optic scope’, ‘fibreoptic intubation’, ‘fiberoptic scope’, ‘fibreoptic stylet’, ‘fibrescope’ ‘Frova catheter', ‘Glidescope’, ‘gum elastic bougie’, ‘hypoxia’, ‘i-gel’, ‘illuminating stylet’, ‘jet ventilation catheter’, ‘laryngeal mask’, ‘laryngeal mask airway Supreme’, ‘laryngoscopy’, ‘lighted stylet’, ‘light wand’, ‘LMA Supreme’, ‘Manujet’, ‘McCoy’, ‘McGrath’, ‘nasotracheal intubation’, ‘obesity’, ‘oesophageal detector device’, ‘oesophageal intubation’, ‘Pentax airway scope’, ‘Pentax AWS’, ‘ProSeal LMA′, ‘Quicktrach’, ‘ramping’, ‘rapid sequence induction’, ‘Ravussin cannula’, ‘Sanders injector’, ‘Shikani stylet’, ‘sugammadex’, ‘supraglottic airway’, ‘suxamethonium’, ‘tracheal introducer’, ‘tracheal intubation’, ‘Trachview’, ‘Tru view’, ‘tube introducer’, ‘Venner APA’, ‘videolaryngoscope’, and ‘videolaryngoscopy’.
The initial search retrieved 16 590 abstracts. The searches (using the same terms) were repeated every 6 months. In total, 23 039 abstracts were retrieved and assessed for relevance by the working group; 971 full-text articles were reviewed. Additional articles were retrieved by cross-referencing the data and hand-searching. Each of the relevant articles was reviewed by at least two members of the working group. In areas where the evidence was insufficient to recommend particular techniques, expert opinion was sought and reviewed.8 (link) This was most notably the situation when reviewing rescue techniques for the ‘can't intubate can't oxygenate’ (CICO) situation.
Opinions of the DAS membership were sought throughout the process. Presentations were given at the 2013 and 2014 DAS Annual Scientific meetings, updates were posted on the DAS website, and members were invited to complete an online survey about which areas of the existing guidelines needed updating. Following the methodology used for the extubation guidelines,5 (link) a draft version of the guidelines was circulated to selected members of DAS and acknowledged international experts for comment. All correspondence was reviewed by the working group.
Frerk C., Mitchell V.S., McNarry A.F., Mendonca C., Bhagrath R., Patel A., O'Sullivan E.P., Woodall N.M, & Ahmad I. (2015). Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. BJA: British Journal of Anaesthesia, 115(6), 827-848.
Publication 2015
Airway Management Anesthesiologist Anesthetist Bronchoscopy Cannula Catheters Dyspnea Emergencies Eructation Esophagus Europeans Frova Hypoxia Intensive Care Intubation Intubation, Intratracheal Laryngoscopy Light Medical Devices Obesity Pharmaceutical Preparations Pressure Rapid Sequence Induction Scandinavians Succinylcholine Sugammadex Trachea Tracheal Extubation
2
Epidemiology of Pediatric Cardiac Arrest
Descriptive statistics are reported as mean (SD), median (25%, 75%), or number (percent) as indicated. Comparisons of continuous variables between two groups were made with t-tests; ANOVA was used for comparisons across three or more groups. Likelihood ratio chi-square analyses were employed when comparing discrete variables across groups. A univariable logistic regression model was used to calculate the odds ratios of survival across age groups and effect of initial cardiac rhythm. Multiple logistic regression was used to model the relationship between survival and potential predictors of outcome. Potential predictors derived from the adult literature and a priori expert opinion included age, witnessed arrest, bystander CPR, EMS scene time (<10 minutes versus ≥ 10 minutes), airway management, and attempts at vascular access.
An analysis of scene time among the pediatric age groups was performed for time <10 minutes. This interval was chosen a priori because the authors considered an EMS scene time <10 minutes as a “scoop and run” approach. Ten minutes was estimated to be the minimum time for EMS providers to arrive at the patient’s side, assess the patient, provide initial resuscitation efforts, and transfer the patient to the transporting vehicle. Post hoc analyses of scene time among the combined pediatric age groups versus adult scene time were performed.
The incidence rates were calculated per 100,000 person-years for the 12-month period March 1, 2006 to February 28, 2007 for both pediatric and adult populations to avoid bias introduced by seasonal variation. Because one site had incomplete data, only 10 sites were included in the incidence calculations. For each site, the age category and sex specific rates were calculated; these rates were standardized by age and sex to the North American population of the US 2000 census and Canadian 2001 census (21.4 million persons within the 10 ROC sites). The site rates, weighted by the site population, were then averaged to obtain overall rates. Additionally to counteract the possibility of incomplete ascertainment at each site, a “hot deck” multiple imputation scheme was used. For a given month, if an agency reported incomplete capture of cases, or if the number of submitted cases was substantially fewer than expected, based on the average agency rate over March to August 2006 (P<0.005), we assumed that ascertainment was not complete for that month at that agency. This was primarily an issue at the start-up of reporting for a few agencies. The number of cases for an agency during such a month was then imputed using a Poisson model adjusted for calendar month and agency within each site. Arrest characteristics such as age and sex for the imputed cases were determined by randomly sampling a case from the agency in question. This imputation was repeated 10 times; incidence rates were averaged over repetitions.12 (link),16 ,17 (link) Imputation was used for 3.5% of the pediatric cases and 5.1% of the adult cases.
These data were collected as part of an observational study that met the requirements for minimal risk research in the US and Canada and was approved by 74 Institutional Review Boards and 34 Research Ethics Boards. The authors had full access to the data and take responsibility for its integrity. All authors have read and agree to the manuscript as written.
Atkins D.L., Everson-Stewart S., Sears G.K., Daya M., Osmond M.H., Warden C.R, & Berg R.A. (2009). Epidemiology and Outcomes from Out-of-Hospital Cardiac Arrest in Children: The ROC Epistry-Cardiac Arrest. Circulation, 119(11), 1484-1491.
Publication 2009
Adult Age Groups Airway Management Blood Vessel Cardiac Arrest Ethics Committees, Research Heart neuro-oncological ventral antigen 2, human North American People Patients Resuscitation
3
Developing Core Data Set for Emergency Medical Services
The consensus process was arranged in a four-step sequence (details of each stage are described below). Stages 1, 2 and 4 were carried out by email. During stage 3, the panel met in Stavanger, Norway for a 2-day consensus meeting.
Keeping proposals anonymous is of major methodological importance to reduce the influence of "loud-speaking" experts and to facilitate the influence of their "silent-speaking" peers [31 (link),38 (link)]. The expert panel members were aware of its composition, but anonymity related to proposals was secured until stage 3.
Stage 1. The expert panel received a predesigned worksheet by email. Each expert was asked to propose the ten most important variables to be routinely documented for shared research and benchmarking within each of five predefined sections:
1. Fixed system variables
Variables relating to system characteristics concerning how the service is organised, the operational capacities of the service and its integration with the EMS with which it operate.
2. Event operational descriptors
Variables documenting the context of a mission (dispatch) or episodes of use (for services with advisory functions).
3. Patient descriptors
Variables documenting information related to the patient's profile, e.g., age, gender, co-morbidity and type of medical complaint.
4. Process mapping
Variables recording what happened to the patient and how the episodes of care proceeded.
5. Outcome and quality indicators
Variables relating to patient and/or mission outcomes, as well as measures of quality.
An optional sixth section for proposals of variables that did not fit into one of the predefined sections was provided. The experts were informed that a subsidiary aim of the process was to establish a core data set that was easy to routinely collect and did not require excessive database alterations.
The project organisers recognised the challenge that several reports on how to document and report data in various parts of emergency care have already been published and implemented [24 (link),32 (link),37 (link),39 (link)]. These templates (e.g., Utstein for cardiac arrest, the Utstein template for major trauma and the Utstein template for the reporting of advanced airway management) contain some common variables with slightly different definitions. The expert panel was supplied these published templates and asked to make the new variables compatible with existing template variables, if feasible.
The proposed variables were returned to the project group by email and systemised. Different variables with identical meaning were combined carefully so as not to interfere with the expert panel's proposals. No single proposed variables were deleted. The variables within each section were ranked according to how many times the variables had been proposed by the different expert panel members.
Stage 2. The revised worksheet containing aggregated results from stage 1 was sent to the expert panel. The panel were then requested to rank the ten most important variables in each section from 10 (most important) to 1 (least important). The variables with no ranking were then removed from the list. The results from this ranking provided the basis for the consensus meeting.
Stage 3. The expert panel gathered in Stavanger, Norway and, during a 2-day meeting, agreed upon a core data set. At this meeting, moderators (DL and HML)) led the experts through the results from stage 2. The experts were divided into two groups and discussed portions of the preliminary dataset. The experts subsequently presented their discussions in plenum, and variables were discussed, debated and agreed upon. The variables were decided upon on day 1 and were defined and categorised on day 2. Some variables were not finally defined during the meeting, and the expert panel approved the project group to propose definitions for the remaining variables before stage 4.
Stage 4. Based on step 3, the final data set, including definitions, was prepared by the project group and submitted to the expert panel for final approval. At this point, no additional variables were accepted, but minor changes related to answer categories and definitions were allowed.
Consensus was defined as agreement on the proposed variables at the consensus meeting among the attending experts. Furthermore, we informed the experts during stage 4 that no response was interpreted as agreement to the final core data set.
Krüger A.J., Lockey D., Kurola J., Di Bartolomeo S., Castrén M., Mikkelsen S, & Lossius H.M. (2011). A consensus-based template for documenting and reporting in physician-staffed pre-hospital services. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 19, 71.
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Publication 2011
Airway Management Cardiac Arrest Episode of Care Gender Patients Service, Emergency Medical Wounds and Injuries
4
Standardized Airway Intervention Protocol
As with previous Utstein-style templates [17 (link),21 (link)], we differentiated between core and optional data variables. We chose to focus on the core data variables, i.e., those data variables that absolutely must be collected. These variables were divided into three groups based on their relationship to the intervention advanced airway management: "system variables", "patient variables", and "post-intervention variables".
Sollid S.J., Lockey D, & Lossius H.M. (2009). A consensus-based template for uniform reporting of data from pre-hospital advanced airway management. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 17, 58.
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Publication 2009
Airway Management Patients
5
Pre-hospital Airway Management in Denmark
The Central Denmark Region covers a mixed urban and rural area of approximately 13000 km2with a population of 1.27 million. The overall population density is 97.7 inhabitants pr. km2.
The standard EU emergency telephone number (1-1-2) covers all Denmark and there is an Emergency Medical Dispatch Centre in each of the five Danish regions. Emergency Medical Dispatch is criteria based.
The Central Denmark Region has a two-tiered EMS system. The first tier consists of 64 ground ambulances staffed with Emergency Medical Technicians (EMTs) on an intermediate or paramedic level (EMT-I / EMT-P). EMTs in The Central Denmark Region do not perform PHETI, nor do they use supraglottic airway devices (SADs).
The second tier consists of ten pre-hospital critical care teams staffed with an anaesthesiologist (with at least 4½ years’ experience in anaesthesia) and a specially trained EMT. Nine of the pre-hospital critical care teams are deployed by rapid response vehicles; the tenth team staffs a HEMS helicopter.
In the most rural parts of the region there are three rapid response vehicles staffed with an EMT and an anaesthetic nurse. The anaesthetic nurses do not use SADs nor do they perform Rapid Sequence Intubation (RSI) or other forms of drug-assisted PHAAM in the pre-hospital setting. These rapid response vehicles were not part of this study.
The pre-hospital critical care teams covered by this study employ approximately 90 anaesthesiologists as part time pre-hospital physicians. There are no full-time pre-hospital critical care physicians in the region – all physicians primarily work in one of the five regional emergency hospitals or at the university hospital. All pre-hospital critical care physicians have in-hospital emergency anaesthesia and advanced airway management both in- and outside the operating theatre as part of their daily work. Intensive care is part of the Danish anaesthesiological curriculum.
All pre-hospital critical care teams carry the same equipment for airway management. This includes equipment for bag-mask-ventilation (BMV), endotracheal tubes and standard laryngoscopes with Macintosh blades (and Miller blades for infants and neonates), intubation stylets, AirTraq™ laryngoscopes, Gum-Elastic Bougies, standard laryngeal masks (LMAs), intubating laryngeal masks (ILMAs) and equipment for establishing a surgical airway. All units are equipped with a capnograph and an automated ventilator. The pre-hospital critical care teams carry a standardised set-up of medications including thiopental, propofol, midazolam and s-ketamine for anaesthesia and sedation, alfentanil, fentanyl and morphine for analgesia and suxametonium and rocuronium as neuro-muscular blocking agents (NMBAs). Lidocain is available for topical anaesthesia.
Our system has no airway management protocols or standard operating procedures (SOPs) regarding PHAAM or pre-hospital RSI [22 (link)] and the physicians use the available drugs and equipment at their own discretion.
The pre-hospital critical care anaesthesiologists in our region have an average of 17.6 years of experience in anaesthesia and on average 7.2 years of experience with pre-hospital critical care. The average pre-hospital critical care physician performs 14.5 endotracheal intubations per month, 1 of them in the pre-hospital setting.
We have previously reported details of the pre-hospital critical care physicians’ education, training, level of experience and equipment-awareness in our region [22 (link)].
We collected data from February 1st 2011 until November 1st 2012.
Follow-up data regarding 30-days mortality were collected in January and February 2013.
Rognås L., Hansen T.M., Kirkegaard H, & Tønnesen E. (2013). Pre-hospital advanced airway management by experienced anaesthesiologists: a prospective descriptive study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 21, 58.
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Publication 2013
Airway Management Alfentanil Ambulances Anesthesia Anesthesiologist Anesthetics Awareness Capnography Cardiac Arrest Critical Care Emergencies Emergency Medical Dispatch Emergency Medical Technicians Fentanyl Hemorrhage Infant Infant, Newborn Intensive Care Intubation Intubation, Intratracheal Ketamine Laryngeal Masks Laryngoscopes Lidocaine Management, Pain Medical Devices Midazolam Morphine Muscle Tissue Nurses Operative Surgical Procedures Paramedical Personnel Pharmaceutical Preparations Physicians Propofol Rapid Sequence Intubation Rocuronium Sedatives Temporal Lobe Thiopental Topical Anesthetics

Most recents protocols related to «Airway Management»

1
Cleft Surgical Repair Outcomes in Pediatric Patients
Following Institutional Ethical Committee approval from Centro Hospitalar Universitário de São João (number 295/21), data were retrospectively collected from reviewing the electronic clinical and anaesthetic records of 102 patients submitted to cleft surgical repair during a five-year period, between 2016 and 2021 in a single paediatric centre in Porto, Portugal. The inclusion criteria were: patients under 18 years of age, diagnosis of cleft lip or palate, submitted to cleft surgical repair and availability of electronic anaesthetic records.
Recorded data included a demographic and clinical profile (age, sex, American Society of Anesthesiologists [ASA] physical status score, type of cleft, associated syndromes and other comorbidities), the anaesthetic approach (anesthetic technique, airway management), perioperative complications (respiratory, cardiovascular) and postoperative evolution (length of hospital stay, intensive care unit admission).
For the purpose of obtaining descriptive statistics, patients were divided into four age groups (less than one year, one to three years, four to 10 years and 11 to 17 years).
Statistical analysis
Data were analysed using the SPSS statistics for Windows version 27.0.1 (IBM Corp., Armonk, NY, USA). Descriptive statistics with numerical data were expressed as median and interquartile range (IQR) while for qualitative variables, absolute (n) and relative frequencies (%) were calculated. Tests of significance (Mann-Whitney U, Chi-square and Fisher’s exact test) were used whenever appropriate. A p-value < 0.05 was considered statistically significant.
Teles D., Rodrigues D., Barros M., Silva A., Maia J, & Ferreira A. (2023). Retrospective Survey and Analysis of Anaesthesia and Outcomes in Paediatric Cleft Lip or Palate Surgery in a Tertiary Care Center, Portugal. Cureus, 15(2), e34711.
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Publication 2023
Age Groups Airway Management Anesthesiologist Anesthetics Biological Evolution Cardiovascular System Diagnosis Lips, Cleft Operative Surgical Procedures Palate Patients Physical Examination Respiratory Rate Syndrome
2
Airway Management Practices Analysis
We performed a post hoc analysis of prospectively collected data from six previously published randomized trials of airway management conducted by the Pragmatic Critical Care Research Group in the United States (1 (link), 10 (link)–14 (link)). The trials enrolled 979 patients undergoing nonelective TI in the ED or ICU between February 2014 and May 2018. We analyzed deidentified data in the trial datasets from patients who were intubated using DL with a Macintosh blade size 4 or 3 on the first attempt; we excluded patients intubated with smaller blade sizes or those for whom data on blade size was missing or a video laryngoscope used on first attempt. Individual trials were approved by the institutional review board (IRB) of each respective site with documented waiver of informed consent by respective site IRB (1 (link), 10 (link)–14 (link)). Studies were carried out per the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975. Details are documented in individual manuscripts. This study was deemed a secondary analysis of a deidentified data set of prior studies and no IRB review was deemed necessary by the IRBs (and thus no number was assigned) as it did not fall under the board’s guidelines as human subjects research.
Landefeld K.R., Koike S., Ran R., Semler M.W., Barnes C., Stempek S.B., Janz D.R., Rice T.W., Russell D.W., Self W.H., Vonderhaar D., West J.R., Casey J.D, & Khan A. (2023). Effect of Laryngoscope Blade Size on First Pass Success of Tracheal Intubation in Critically Ill Adults. Critical Care Explorations, 5(3), e0855.
Publication 2023
Airway Management Critical Care Ethics Committees, Research Homo sapiens Lamina 4 Laryngoscopes Patients
3
Extracorporeal CPR Effectiveness Protocol
ECPR was the primary exposure and was defined as successful venoarterial ECMO implantation and a pump-on during the cardiac massage; therefore, ECMO pump-on time was documented as before the last ROSC.
We collected information on age, sex, medical history (diabetes mellitus, hypertension, heart disease, and stroke), place of cardiac arrest (public or others), and bystander CPR (yes or no). We also collected information on the type of initial cardiac rhythm (shockable or pulseless electrical rhythm, asystole), prehospital management (defibrillation, fluid administration, mechanical CPR, and advanced airway management [endotracheal intubation or supraglottic airway management] by EMS providers), response time interval (call to the arrival of the ambulance at the scene), scene time interval (arrival to departure from the scene), transport time interval (departure from the scene to arrival at the ED), any prehospital ROSC prior to ED arrival, percutaneous coronary intervention, and targeted temperature management. For targeted temperature management, only the data from the cases where an explicit body temperature control method and target body temperature were specified with core body temperature monitoring, were collected. ECPR-related variables, including the location of ECPR (ED, catheterisation laboratory, or others) and total ECLS duration (time from ECMO pump-on to ECMO turn-off time), were also collected.
Choi Y., Park J.H., Jeong J., Kim Y.J., Song K.J, & Shin S.D. (2023). Extracorporeal cardiopulmonary resuscitation for adult out-of-hospital cardiac arrest patients: time-dependent propensity score-sequential matching analysis from a nationwide population-based registry. Critical Care, 27, 87.
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Publication 2023
Airway Management Ambulances Body Temperature Cardiac Arrest Catheterization Cerebrovascular Accident Diabetes Mellitus Electric Countershock Electricity Extracorporeal Membrane Oxygenation Heart Heart Diseases Heart Massage High Blood Pressures Hypothermia, Induced Intubation, Intratracheal Ovum Implantation Percutaneous Coronary Intervention Venoarterial ECMO
4
OHCA Care in Korean EMS System
This cross-sectional study was conducted using a prospectively collected nationwide emergency medical service (EMS)-based OHCA registry from Korea. This study was approved by the Institutional Review Board (IRB) of the study institution (IRB No. 1103-153-357). The requirement for informed consent was waived.
The National Fire Agency operates a prehospital EMS system exclusively in Korea. In cases of OHCA, all EMS providers can provide basic life support, and qualified EMS providers can provide advanced life support, including advanced airway management, intravenous catheter insertion, or epinephrine use under direct medical control. EMS providers have no authority to declare death or stop CPR unless there is ROSC, and all OHCA patients should be transported to the hospital. There is no prehospital ECMO programme in Korea; therefore, all ECPR procedures can be performed in a hospital.
The Korean Ministry of Health has designated the following three levels of emergency department (ED): level 1 (n = 36) and level 2 (n = 119), which provide the highest level of emergency care services with emergency physicians on staff all times, and level 3 (n = 261), which may be staffed by general physicians. All EDs generally perform acute cardiac care and post-resuscitation care in accordance with national guidelines national guidelines that were adapted from the American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care [18 (link), 19 (link)]. No major differences in post-resuscitation care recommendations were observed between the two guidelines. In 2020, 74 EDs conducted at least one extracorporeal life support (ECLS) intervention for OHCA patients (median [interquartile range] volume of ECLS for OHCA 4 (2–6). The decision to perform ECPR is determined by attending physicians at each centre, and eligibility criteria using age, comorbidities, and cardiac rhythm can be used according to the centre [20 (link)–22 (link)]. In most centres, ECPR is performed by thoracic surgeons or cardiologists rather than an emergency physician.
Choi Y., Park J.H., Jeong J., Kim Y.J., Song K.J, & Shin S.D. (2023). Extracorporeal cardiopulmonary resuscitation for adult out-of-hospital cardiac arrest patients: time-dependent propensity score-sequential matching analysis from a nationwide population-based registry. Critical Care, 27, 87.
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Publication 2023
Airway Management Cardiologists Cardiopulmonary Resuscitation Cardiovascular System Catheterization Eligibility Determination Emergencies Epinephrine Ethics Committees, Research Extracorporeal Membrane Oxygenation General Practitioners Heart Koreans Patients Physicians Prehospital Emergency Care Resuscitation Service, Emergency Medical Surgeons
5
ECMO for Severe Airway Obstruction
All methods were performed in accordance with the relevant guidelines and regulations, and approved by the Ethics Committee on Biomedical, West China Hospital of Sichuan University (Number: 2021-233). It was a single-center, retrospective small sample study based on real-world. Informed consents were obtained from all patients when they were admitted to our emergency center. The center of West China Hospital, Sichuan University had professional ECMO team and respiratory ICU.
Traditional respiratory supports had extremely limited effect for severe central airway obstruction patients caused by neck and chest tumors.
To explore feasibility of early ECMO initiation as an effective first-aid manner for these patients, we reviewed clinical records of patients between January 2021 and December 2021. Severe central airway obstruction caused by neck and chest tumors, unfeasible traditional respiratory supports and early ECMO intervention were eligible for inclusion. Patients were selected by our respiratory MDT, based on criteria of Practice Guidelines for Management of Difficult Airway (2022 version), presented by American Society of Anesthesiologists (ASA)21 (link),22 (link). 3 patients were completely eligible for inclusion standard. There was no control group. Because it was life-threating for severe central airway obstruction patients caused by neck and chest tumors to use traditional manner. Establishing adequate ventilation was safest for patients. Therefore, we were unable to set control group with traditional manner to compare with ECMO group. We obtained the demographic characteristics, clinical features, blood tests, radiological managements, surgical procedures, pathological examinations, ECMO details and survival outcomes to make a true presentation. Presenting how to build emergency ventilation for severe central airway obstruction patients caused by neck and chest tumors was our primary objective. Central airway obstruction caused by neck and chest tumors is very dangerous oncological emergency with increasing incidence. Discussing an effective first-aid plan to save their life was our secondary objective.
In this part, we showed detailed clinical experience to make that every center could repeat this procedure in the same manner. The primary step was central airway obstruction caused by neck and chest tumors verified by CT performed before treatment. The CT outcomes were interpreted by experienced radiologist or emergency physician. Evaluation and management of difficult airway were performed by anesthesiologist at patient bedside. If traditional managements was useless and even life-threating, ECMO as a significant device could be recommend to provide adequate ventilation. Under ECMO support, surgical procedures were carried out. Conflict between anticoagulation and surgical bleeding should be pay attention. Pharmacokinetics of heparin was important. Kidney played a key role in heparin clearance. Renal function test was significant before using heparin. In our center, firstly, heparin-free was attempted when ECMO was running to provide adequate ventilation. Secondly, coagulation function was tested until reaching surgical standard. Thirdly, surgical procedures were performed during ECMO running without heparin. Lastly, anticoagulation was restarted after operations with acceptable surgical bleeding. All details and variables were recorded.
Liang L., Su S., He Y., Peng Y., Xu S., Liu Y., Zhou Y, & Yu H. (2023). Early extracorporeal membrane oxygenation as bridge for central airway obstruction patients caused by neck and chest tumors to emergency surgery. Scientific Reports, 13, 3749.
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Publication 2023
Airway Management Airway Obstruction Anesthesiologist Attention Coagulation, Blood Disease Management Drug Kinetics Early Intervention (Education) Emergencies Ethics Committees Extracorporeal Membrane Oxygenation First Aid Hematologic Tests Heparin Kidney Kidney Function Tests Medical Devices Neck Neoplasms Operative Surgical Procedures Patients Patient Safety Physical Examination Physicians Radiologist Respiratory Rate Thoracic Neoplasms X-Rays, Diagnostic

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More about "Airway Management"

Airway management is a critical aspect of healthcare, encompassing the techniques and devices used to secure, protect, and maintain an unobstructed airway during medical procedures, emergencies, and intensive care.
This multifaceted field is essential for ensuring adequate ventilation, oxygenation, and patient safety across diverse healthcare settings.
Some key subtopics within airway management include intubation, tracheostomy, and the use of airway devices such as laryngeal masks, endotracheal tubes, and bag-valve-mask ventilation.
Effective airway management requires the mastery of various skills and the proper utilization of specialized equipment like the Airway Management Trainer, EB-580T, BF-1T290, BF-260, and Standard type intlock blade for AWS.
Simulation-based training, using tools like SimMan 3G, EB-580S, and BF-1T260, can help healthcare professionals develop and maintain proficiency in airway management.
Additionally, the UM-S20-17S and α-GalCer are examples of related terms and technologies that may be relevant to this field.
Staying up-to-date with the latest research, protocols, and innovations is crucial for optimizing airway management and delivering the best possible patient outcomes.
By leveraging AI-driven platforms like PubCompare.ai, healthcare professionals can effortlessly locate and compare the most relevant literature, pre-prints, and patents, taking their airway management research and practice to new heights.