What’s new in airway management of the critically ill

Excerpt

Airway management, including tracheal intubation (TI) and tracheostomy constitute the most commonly performed procedures in critically ill patients. Critically ill patients have a ‘physiologically difficult’ airway, i.e. where the underlying hypoxaemia, hypotension, metabolic acidosis and other pathophysiologic changes substantially increase the risk of complications during TI. In contrast to patients in the operating room, factors such as the emergent nature of airway management, the increased risk of aspiration, variable levels of operator experience, less advanced equipment and complex intubating conditions, pose significant additional challenges during TI in these patients. In addition, a proportion of these critically ill patients will also have ‘anatomically’ difficult airways, further increasing risk for adverse airway-related outcomes [1]. …