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Best Method to Establish the Grade of Difficult Airway. Clinical Assessment, Techniques and Procedures in Critical Care and ICU

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Anaesthesia, Pain, Intensive Care and Emergency A.P.I.C.E.

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Abstract

Due to advances in training, technology and guidelines implementation, elective airway management within the setting of the Operating Room (OR) can be associated with very low complication rates [1]. There has been a heightened awareness and a steady rise in the amount of literature published on the prediction of difficult airways for anaesthesia purposes. Unfortunately none of the suggested methods provide satisfactory results in terms of sensitivity and specificity: at least for now, reliable prediction of difficult airway management (DAM) is likely to remain a decision-making process based on clinical judgment, and this is particularly true in emergency situations and critical illness [2]. Furthermore, the epidemiology of DAM varies according to the different definitions used and the population studied in the large amount of literature on the subject [3]. Complication rates in the Intensive Care Unit (ICU) environment are also much higher due to the inability, in the majority of cases, to perform a thorough evaluation of the patient’s anatomy prior to airway instrumentation.

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References

  1. Cheney FW (2002) Changing trends in anaesthesia-related death and permanent brain damage. ASA Newsletter 66(6) http://asahq.org/newsletter/2002 /6_02/cheney.html

    Google Scholar 

  2. Walz JM, Zayaruzny M, Heard SO (2007) Airway Management in Critical Illness. Chest 131:608–620

    Article  PubMed  Google Scholar 

  3. Walls RM, Viesser RM (2007) The traumatized patient. In: Hagberg C. (2nd ed) Benumof’s Airway Management. Mosby Elsevier, Philadelphia, pp. 939–960

    Google Scholar 

  4. Gruppo di Studio SIAARTI Vie Aeree Difficili (2005) Recommendations for airway control and difficult airway management. Minerva Anestesiol 71:617–657

    Google Scholar 

  5. Sorbello M, Petrini F, Gullo A (2006) La gestione delle vie aeree in area intensivologica. Minerva Anestesiol 72Suppl 1, 456–459

    Google Scholar 

  6. Hagberg C, Satyajeet G (2004) Does the airway examination predict difficult intubation? In: Fleisher LA (ed) Evidence-based practice of anesthesiology. Saunders Elsevier, Philadelphia, pp. 34–46

    Google Scholar 

  7. European Resuscitation Council (2005) Guidelines for Resuscitation. Section 7. Cardiac arrest in special circumstances. Resuscitation 67S1, S135–S170

    Google Scholar 

  8. Reynolds SF, Heffner J (2005) Airway management of the critically ill patient. Rapidsequence intubation. Chest 127:1397–1412

    Article  PubMed  Google Scholar 

  9. Mellin-Olsen J, O’Sullivan E, Petrini F et al (Working Party on Safety and Quality of Care. Section and Board of Anaesthesiology UEMS) (2007) Guidelines for safety and quality in anaesthesia practice in the European Union. EJA 24:479–482

    Article  CAS  Google Scholar 

  10. Rall M, Dieckmann P (2005) Safety culture and crisis resource management in airway management: General principles to enhance patient safety in critical airway situations. Best Practice & Research Clinical Anaesthesiology 19:539–557

    Article  Google Scholar 

  11. Gordini G, Petrini F, Gruppo di lavoro SIAARTI-IRC (2005) L’organizzazione della risposta intra-ospedaliera: survey SIAARTI-IRC e principi delle linee guida. Minerva Anestesiol 71:406–407

    Google Scholar 

  12. Petrini F, Cerchiari E (2006) In-hospital emergencies: SIAARTI/IRC recommendations for the short and long term. Minerva Anestesiol 72:429–432

    Google Scholar 

  13. Hanson CW, Durbin Jr. CG, Maccioli GA et al (2001) The anesthesiologist in critical care medicine. Past, present, and future. Anesthesiology 95:781–788

    Article  PubMed  Google Scholar 

  14. Behringer HC (2001) The intensive care unit: the role of the anesthesiologist as a perioperative consultant. ASA Refresher Course 266:1–6

    Google Scholar 

  15. Lim MST, Hunt-Smith JJ (2003) Difficult airway management in the intensive care unit: practical guidelines. Critical Care and Resuscitation 5:43–52

    PubMed  CAS  Google Scholar 

  16. Hlava N, Wiener-Kronish J, Campbell L (2005) Intensivist management of difficult airway problems. Critical Care/Respiratory Care. Clinical Pulmonary Medicine 12:309–318

    Article  Google Scholar 

  17. Yentis SM (2002) Predicting difficult intubation: worthwhile exercise or pointless ritual? Anaesthesia 57:105–109

    Article  PubMed  CAS  Google Scholar 

  18. Karkouti K, Rose DK, Wigglesworth D et al (2000) Predicting difficult intubation: a multivariable analysis. Can J Anesth 47:730–739

    Article  PubMed  CAS  Google Scholar 

  19. Krobbuaban B, Diregpoke E, Kumkeaw S (2005) The predictive value of the height ratio and thyromental distance. Four predictive tests for difficult laryngoscopy. Anesth Anal 101:1542–1545

    Article  Google Scholar 

  20. Cattano D, Paolicchi A, Petrini F et al (2005) Airway management: development and routinary use of an assessment form. From Pisa and Chieti to Houston”. Minerva Anestesiol 71:98

    Google Scholar 

  21. Shiga T, Wajima Z., Inoue T et al (2005) Predicting difficult intubation in apparently normal patients. Anesthesiology 103:429–437

    Article  PubMed  Google Scholar 

  22. Cattano D, Panicucci E, Paolicchi A et al (2004) Risk factors assessment of the difficult airway: an Italian survey of 1956 patients. Anesth Analg 99:1774–1779

    Article  PubMed  CAS  Google Scholar 

  23. Lee A, Fan LTY, Gin T et al (2006) Systematic review (meta-analysis) of the accuracy of the Mallampati tests to predict the difficult airway. Anest Analg 102:1867–1878

    Article  Google Scholar 

  24. Naguib M, Scamman FL, O’Sullivan C et al(2006) Predictive performance of three multivariate difficult tracheal intubation models: a double-blind case-controlled study. Anaest Analg 102:818–824

    Article  Google Scholar 

  25. Paix AD, Williamson JA, Runciman WB (2005) Crisis management during anaesthesia: difficult intubation. Qual Saf Health Care 14:e5

    Article  Google Scholar 

  26. Murphy M, Walls RM (2005) Identification of the difficult and failed airway. In: Walls RM (2nd ed): Manual of emergency airway. Lippincott Williams and Wilkins, Philadelphia, pp. 70–81

    Google Scholar 

  27. Petrini F, Scoponi M, Sulpizio J et al (2006) Systematically teaching assessment in prediction of difficult airway. EJA 23suppl 37, A1012:260

    Google Scholar 

  28. EBA-UEMS (2001) Training guidelines in anaesthesia of the European Board of Anaesthesiology Reanimation and Intensive Care. EJA 18:563–571

    Article  Google Scholar 

  29. Burkle CM, Walsh MT, Harrison B et al (2005) Airway management after failure to intubate by direct laryngoscopy: outcomes in a large teaching hospital. Can J Anesth 52:634–640

    PubMed  Google Scholar 

  30. Rosenstock C, Hansen EG, Kristensen MS et al (2006) Qualitative analysis of unanticipated difficult airway managementr. Acta Anaesthesiol Scand 50:290–297

    Article  PubMed  CAS  Google Scholar 

  31. Trentman TL, Frasco PE, Milde LN et al (2004) Utility of letters sent to patient after difficult airway management. J Clin Anesth:257–261

    Google Scholar 

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Author information

Authors and Affiliations

  1. Anaesthesiology and Intensive Care, University G. D’Annunzio Chieti-Pescara, Chieti, Italy

    F. Petrini & L. Moggia

  2. Centro Cardiologico Monzino, Milan, Italy

    G. Merli

Authors
  1. F. Petrini
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  2. L. Moggia
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  3. G. Merli
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Editor information

Editors and Affiliations

  1. Department of Anaesthesia and Intensive Care Head, Postgraduated School of Anaesthesia and Intensive Care, Catania University Hospital, Catania, Italy

    Antonino Gullo M.D. (Head) (Head)

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© 2008 Springer-Verlag Italia

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Petrini, F., Moggia, L., Merli, G. (2008). Best Method to Establish the Grade of Difficult Airway. Clinical Assessment, Techniques and Procedures in Critical Care and ICU. In: Gullo, A. (eds) Anaesthesia, Pain, Intensive Care and Emergency A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-0773-4_7

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  • DOI: https://doi.org/10.1007/978-88-470-0773-4_7

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0772-7

  • Online ISBN: 978-88-470-0773-4

  • eBook Packages: MedicineMedicine (R0)

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