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RESEARCH PRODUCT
Review of difficult airway management in thoracic surgery
A. VillalongaM.c. UnzuetaJ.m. CalvoL. GallartM. GranellO. ValenciaA. PlanasM.j. ParraM.j. Jiménezsubject
medicine.medical_specialtyLungbusiness.industrymedicine.medical_treatmentTracheal intubationLumen (anatomy)030208 emergency & critical care medicineGeneral Medicinerespiratory systemSugammadexrespiratory tract diseasesSurgery03 medical and health sciences0302 clinical medicinemedicine.anatomical_structure030202 anesthesiologyCardiothoracic surgeryAnesthesiaMedicineAirway managementRocuroniumbusinessAirwaymedicine.drugdescription
The management of difficult airway (DA) in thoracic surgery is more difficult due to the need for lung separation or isolation and frequent presence of associated upper and lower airway problems. We performed an article review analysing 818 papers published with clinical evidence indexed in Pubmed that allowed us to develop an algorithm. The best airway management in predicted DA is tracheal intubation and independent bronchial blockers guided by fibroscopy maintaining spontaneous ventilation. For unpredicted DA, the use of videolaryngoscopes is recommended initially, and adequate neuromuscular relaxation (rocuronium/sugammadex), among other maneuvers. In both cases, double lumen tubes should be reserved for when lung separation is absolutely indicated. Finally, extubation should be a time of maximum care and be performed according to the safety measures of the Difficult Arway Society.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2018-01-01 | Revista Española de Anestesiología y Reanimación (English Edition) |