Tracheal extubation of the adult intensive care patient with a predicted difficult airway - a narrative review.
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.
Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia.
D J
DJ
Sturgess
Department of Anaesthesiology, University of Hong Kong, Hong Kong SAR.
K B
KB
Greenland
School of Medicine, James Cook University, Townsville, Queensland, Australia.
S
S
Senthuran
Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
F A
FA
Ajvadi
Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.|School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
A
A
van Zundert
Department of Anaesthesiology, University of Hong Kong, Hong Kong SAR.
M G
MG
Irwin
D000328:Adult; D060666:Airway Extubation / Q000295:instrumentation / Q000379:methods*; D057785:Catheters; D003422:Critical Care; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000295:instrumentation; D015300:Ventilator Weaning
airway extubation; endotracheal extubation; extubation; intra-tracheal; tracheal extubation