Réfllexions sur la balance Airway/complications

Strategies for the prevention of airway complications - a narrative review.

Cook TM.  Anaesthesia. 2018 Jan;73(1):93-111. doi: 10.1111/anae.14123.

 

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Le document rapporté est une lecture critique de la littérature sur un sujet de premier plan. La démarche dépasse celle d'un anesthésiste-réanimateur pour être centrée sur la prévention des complications liées à la gestion de l'airway.

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Despite being infrequent, complications of airway management remain an important contributor to morbidity and mortality during anaesthesia and care of the critically ill. Developments in the last three decades have made anaesthesia safer, and this has been mirrored in the equipment and techniques available for airway management. Modern technology including novel oxygenation modalities, widespread availability of capnography, second-generation supraglottic airway devices and videolaryngoscopy provide the tools to make airway management safer still. However, technology will only take safety so far, and non-technical aspects of airway management are critically important for communication and decision making during airway crises, acknowledging a 'cannot intubate, cannot oxygenate' situation and transitioning to emergency front of neck airway. Randomised controlled trials provide little useful information about safety in this setting, and data from registries and databases are likely to be of more value. This narrative review focuses on recent evidence in this area.