, Volume 27, Issue 1, pp 157-160
Date: 05 Dec 2012

Strategies for difficult airway management—the current state is not ideal

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T. Asai

Any problems with current airway management?

Failure to secure a clear airway can be fatal. Historically, a report (in 1990) of US closed claim analysis related to anesthesia practice during 1975–1984 indicated that adverse outcomes involving the respiratory system had comprised the single largest class of injury, and that the incidence of death or permanent brain damage associated with airway management was strikingly much higher (85 %) than the incidence associated with cardiovascular management (30 %) [1].

Since then, several major efforts have been made to reduce complications associated with airway management [2]. Routine use of a capnograph and a pulse oximeter has certainly reduced the incidence of unrecognized esophageal intubation, disconnection of the breathing system, or kinking of a tracheal tube. Improvement of tracheal tube design and development of new airway devices (e.g. videolaryngoscopes) have reduced the incidence of difficult tracheal intubation [3, 4]. Severa ...