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Tracheal extubation of the adult intensive care patient with a predicted difficult airway – a narrative review
Author(s) -
Sturgess D. J.,
Greenland K. B.,
Senthuran S.,
Ajvadi F. A.,
Zundert A.,
Irwin M. G.
Publication year - 2017
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.13668
Subject(s) - medicine , intensive care medicine , airway , intensive care , airway management , intensive care unit , intubation , narrative review , tracheal intubation , critically ill , patient safety , anesthesia , health care , economics , economic growth
Summary Management of the difficult airway is an important, but as yet poorly‐studied, component of intensive care management. Although there has been a strong emphasis on prediction and intubation of the difficult airway, safe extubation of the patient with a potentially difficult airway has not received the same attention. Extubation is a particularly vulnerable time for the critically ill patient and, because of the risks involved and the consequences of failure, it warrants specific consideration. The Royal College of Anaesthetists 4th National Audit Project highlighted differences in the incidence and consequences of major complications during airway management between the operating room and the critical care environment. The findings in the section on Intensive Care and Emergency Medicine reinforce the importance of good airway management in the critical care environment and, in particular, the need for appropriate guidelines to improve patient safety. This narrative review focuses on strategies for safe extubation of the trachea for patients with potentially difficult upper airway problems in the intensive care unit.