Recomendaciones para el manejo de la Vía Aérea Difícil. 1ª Parte. La Vía Aérea Difícil Imprevista
DOI:
https://doi.org/10.30445/rear.v6i4.221Palabras clave:
dificultad intubación, guía, oxigenación, vad, vía aérea difícil previstaResumen
Todos sabemos que los predictores de intubación difícil son imperfectos, y que el fracaso de la intubación endotraqueal mediante Laringoscopia Directa (LD) u otra técnica puede ocurrir de forma inesperada. Encontrarnos una intubación traqueal difícil con el paciente inconsciente tras la inducción de la Anestesia General (AG) siempre es motivo de preocupación, ya que la realización de múltiples intentos de intubación traqueal aumenta de forma significativa la morbimortalidad (1-5). Para realizar esta revisión se reformó el Grupo de Vía Aérea Canadiense (Canadian Airway Focus Group [CAFG]), creado inicialmente en 1.990 con representantes de Anestesia, Intensivos y Urgencias, y que publicó sus recomendaciones para el manejo de la VAD Imprevista en 1.998.
Citas
1.- Sakles JC, Chiu S, Mosier J, Walker C, Stolz U. The importance of first pass success when performing orotracheal intubation in the emergency department. Acad Emerg Med. 2013;20:71–78.
2.- Hasegawa K, Shigemitsu K, Hagiwara Y, et al. Association between repeated intubation attempts and adverse events in emergency departments: an analysis of a multicenter prospective observational study.Ann Emerg Med. 2012;60:749–754.
3.- Martin LD, Mhyre JM, Shanks AM, Tremper KK, Kheterpal S. 3,423 emergency tracheal intubations at a university hospital: airway outcomes and complications. Anesthesiology. 2011;114:42–48.
4.- Griesdale DE, Bosma TL, Kurth T, Isac G, Chittock DR. Complications of endotracheal intubation in the critically ill. Intensive Care Med. 2008;34:1835–1842.
5.- Mort TC. Emergency tracheal intubation: complications associated with repeated laryngoscopic attempts. Anesth Analg. 2004;99:607–613.
6.- Cormack RS, Lehane J. Difficult tracheal intubation in obstetrics. Anaesthesia. 1984;39:1105–1111.
7.- Cook TM. A new practical classification of laryngeal view. Anaesthesia. 2000;55:274–279.
8.- Yentis SM, Lee DJ. Evaluation of an improved scoring system for the grading of direct laryngoscopy.Anaesthesia. 1998;53:1041–1044.
9.- Crosby ET, Cooper RM, Douglas MJ, et al. The unanticipated difficult airway with recommendations for management. Can J Anaesth. 1998;45:757–776.
10.-Laevaluacion de la calidad de la evidencia y graduación de la fuerza de las recomendaciones mediante el sistemagrade. Guías Fisterra
11.- Guyatt G, Gutterman D, Baumann MH, et al. Grading strength of recommendations and quality of evidence in clinical guidelines: report from an American College of Chest Physicians Task Force. Chest.2006;129:174–181.
12.- Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336:924–926.
13.-Walls RM. The emergency airway algorithms. In: Walls RM, Murphy MF, Luten RC, Schneider RE, editors. Manual of Emergency Airway Management. Philadelphia: Lippincott Williams & Wilkins; 2004. pp. 8–21.
14.- Law JA, Broemling N, Cooper RM, Drolet P, Duggan LV, Griesdale DE, Hung OR, Jones PM, Kovacs G, Massey S, Morris IR, Mullen T, Murphy MF, Preston R, Naik VN, Scott J, Stacey S, Turkstra TP, Wong DT; Canadian Airway Focus Group. The difficult airway with recommendations for management--part 2--the anticipated difficult airway. Can J Anaesth. 2013 Nov;60(11):1119-38. doi: 10.1007/s12630-013-0020-x. Epub 2013 Oct 17.
15.-Cook TM, Woodall N, Frerk C; Fourth National Audit Project. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. (web)
16.- Cook TM, Nolan JP. Use of capnography to confirm correct tracheal intubation during cardiac arrest. Anaesthesia. 2011;66:1183–1184.
17.- Heinrich S, Birkholz T, Ihmsen H, Irouschek A, Ackermann A, Schmidt J. Incidence and predictors of difficult laryngoscopy in 11,219 pediatric anesthesia procedures. Paediatr Anaesth. 2012;22:729–736.
18.-Murat I, Constant I, Maud’huy H. Perioperative anaesthetic morbidity in children: a database of 24,165 anaesthetics over a 30-month period. Paediatr Anaesth. 2004;14:158–166.
19.-Weiss M, Dullenkopf A, Fischer JE, Keller C, Gerber AC, European Paediatric Endotracheal Intubation Study Group Prospective randomized controlled multi-centre trial of cuffed or uncuffed endotracheal tubes in small children. Br J Anaesth. 2009;103:867–873.
20.- Dorsey DP, Bowman SM, Klein MB, Archer D, Sharar SR. Perioperative use of cuffed endotracheal tubes is advantageous in young pediatric burn patients. Burns. 2010;36:856–860.
21.- Gopalareddy V, He Z, Soundar S, et al. Assessment of the prevalence of microaspiration by gastric pepsin in the airway of ventilated children. Acta Paediatr. 2008;97:55–60.
22.-Cook T, Woodall N, Frerk C. 4th National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br J Anaesth. 2011 May;106(5):617-31. doi: 10.1093/bja/aer058. Epub 2011 Mar 29.
2.- Hasegawa K, Shigemitsu K, Hagiwara Y, et al. Association between repeated intubation attempts and adverse events in emergency departments: an analysis of a multicenter prospective observational study.Ann Emerg Med. 2012;60:749–754.
3.- Martin LD, Mhyre JM, Shanks AM, Tremper KK, Kheterpal S. 3,423 emergency tracheal intubations at a university hospital: airway outcomes and complications. Anesthesiology. 2011;114:42–48.
4.- Griesdale DE, Bosma TL, Kurth T, Isac G, Chittock DR. Complications of endotracheal intubation in the critically ill. Intensive Care Med. 2008;34:1835–1842.
5.- Mort TC. Emergency tracheal intubation: complications associated with repeated laryngoscopic attempts. Anesth Analg. 2004;99:607–613.
6.- Cormack RS, Lehane J. Difficult tracheal intubation in obstetrics. Anaesthesia. 1984;39:1105–1111.
7.- Cook TM. A new practical classification of laryngeal view. Anaesthesia. 2000;55:274–279.
8.- Yentis SM, Lee DJ. Evaluation of an improved scoring system for the grading of direct laryngoscopy.Anaesthesia. 1998;53:1041–1044.
9.- Crosby ET, Cooper RM, Douglas MJ, et al. The unanticipated difficult airway with recommendations for management. Can J Anaesth. 1998;45:757–776.
10.-Laevaluacion de la calidad de la evidencia y graduación de la fuerza de las recomendaciones mediante el sistemagrade. Guías Fisterra
11.- Guyatt G, Gutterman D, Baumann MH, et al. Grading strength of recommendations and quality of evidence in clinical guidelines: report from an American College of Chest Physicians Task Force. Chest.2006;129:174–181.
12.- Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336:924–926.
13.-Walls RM. The emergency airway algorithms. In: Walls RM, Murphy MF, Luten RC, Schneider RE, editors. Manual of Emergency Airway Management. Philadelphia: Lippincott Williams & Wilkins; 2004. pp. 8–21.
14.- Law JA, Broemling N, Cooper RM, Drolet P, Duggan LV, Griesdale DE, Hung OR, Jones PM, Kovacs G, Massey S, Morris IR, Mullen T, Murphy MF, Preston R, Naik VN, Scott J, Stacey S, Turkstra TP, Wong DT; Canadian Airway Focus Group. The difficult airway with recommendations for management--part 2--the anticipated difficult airway. Can J Anaesth. 2013 Nov;60(11):1119-38. doi: 10.1007/s12630-013-0020-x. Epub 2013 Oct 17.
15.-Cook TM, Woodall N, Frerk C; Fourth National Audit Project. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. (web)
16.- Cook TM, Nolan JP. Use of capnography to confirm correct tracheal intubation during cardiac arrest. Anaesthesia. 2011;66:1183–1184.
17.- Heinrich S, Birkholz T, Ihmsen H, Irouschek A, Ackermann A, Schmidt J. Incidence and predictors of difficult laryngoscopy in 11,219 pediatric anesthesia procedures. Paediatr Anaesth. 2012;22:729–736.
18.-Murat I, Constant I, Maud’huy H. Perioperative anaesthetic morbidity in children: a database of 24,165 anaesthetics over a 30-month period. Paediatr Anaesth. 2004;14:158–166.
19.-Weiss M, Dullenkopf A, Fischer JE, Keller C, Gerber AC, European Paediatric Endotracheal Intubation Study Group Prospective randomized controlled multi-centre trial of cuffed or uncuffed endotracheal tubes in small children. Br J Anaesth. 2009;103:867–873.
20.- Dorsey DP, Bowman SM, Klein MB, Archer D, Sharar SR. Perioperative use of cuffed endotracheal tubes is advantageous in young pediatric burn patients. Burns. 2010;36:856–860.
21.- Gopalareddy V, He Z, Soundar S, et al. Assessment of the prevalence of microaspiration by gastric pepsin in the airway of ventilated children. Acta Paediatr. 2008;97:55–60.
22.-Cook T, Woodall N, Frerk C. 4th National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. Br J Anaesth. 2011 May;106(5):617-31. doi: 10.1093/bja/aer058. Epub 2011 Mar 29.
Publicado
2014-04-30
Cómo citar
Martínez Hurtado, E., & Sánchez Merchante, M. (2014). Recomendaciones para el manejo de la Vía Aérea Difícil. 1ª Parte. La Vía Aérea Difícil Imprevista. Revista Electrónica AnestesiaR, 6(4), 2. https://doi.org/10.30445/rear.v6i4.221
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