[Algorithms for oxygenation and difficult intubations in obstetrics].
The obstetrical population is prone to difficult or failed intubation. Control of the airway is complicated by several factors specific to obstetric anesthesia; time of apnea is short due to a reduced functional residual capacity, pregnancy-induced hypertension and obesity are relatively frequent; anesthetist's skill can also be mentioned. The best approach to this problem lies in its prevention, using epidural analgesia as soon as possible. Furthermore, the number of difficult intubations can be considerably reduced by a thorough pre-anesthetic examine. Each anesthetist must keep an algorithm in mind, should a difficult or failed intubation in obstetrical patient. Whichever method is used (ventilation through a facial mask or laryngeal mask, transtracheal oxygenation), the anesthetist must never forget that the first priority is always the safety of the mother.
Thorin
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D
CHUV, Lausanne, Suisse.
D000465:Algorithms; D003663:Decision Trees; D005260:Female; D005652:Functional Residual Capacity; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods*; D009774:Obstetrics / Q000379:methods*; D010102:Oxygen Inhalation Therapy / Q000295:instrumentation / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D012307:Risk Factors; D013997:Time Factors