Airway management in critically sick in intensive care | [Anaesthesia, Pain and Intensive Care • 2018]

Author(s):

1. S. K. Malhotra: Department of Anesthesiology, Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Mullana, Ambala-133207, (India)

2. Komal Gandhi: Department of Anesthesiology & Intensive Care, The Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, 160012, India

3. Malhotra SK: Department of Anesthesiology & Intensive Care, The Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, 160012, India

4. Gandhi K.: Department of Anesthesiology & Intensive Care, The Postgraduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, 160012, India

Abstract:

In critically ill patients in Intensive Care Unit (ICU), patency of airway and management of dificult airway are of utmost importance. The incidence of dificult intubation may be 10% to 22% depending on the various factors in patient as well as availability of equipment facilities. As compared to the regular surgery in operation theatre, the management of airway in critically ill patients is considerably different and more challenging. The physiological reserve and co-morbidities are more common in critically ill patients. In ICU, recent techniques of airway management must be considered and practiced, such as videolaryngoscope (VLS), fiberoptic bronchoscope and supraglottic devices. The success for airway management would be greater if airway expert, the required devices and an adequate protocol are available. The outcome of managing airway would be enhanced if best use of available airway devices in a particular hospital setup since every instrument may not be available. The standard guidelines for dificult airway and the protocol of individual hospital may reduce the complications; hence must be followed. The availability of dificult airway cart and capnograph is a must. The indications and timing of surgical airway must be clear to the airway team. The Training courses for the staf in ICU should be held regularly to apprise them of advancement in airway management. The best use of available airway equipment should be made in critically ill patients. At least, one airway expert must be accessible in ICU at any given time.

Page(s): 21-28

DOI: DOI not available

Published: Journal: Anaesthesia, Pain and Intensive Care, Volume: 22, Issue: SI, Year: 2018

Keywords:

Tracheal intubation , Tracheostomy , Extubation , Endotracheal tube , Supraglottic devices , Videolaryngoscope , Tube exchanger

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