Recent advances in airway management

Abstract

Airway management is a core skill essential for anaesthesiologists and health care providers involved in resuscitation and acute care of patients. Advancements in airway management are continuously evolving. This narrative review highlights the recent advancements with respect to innovations, tools, techniques, guidelines, and research in both technical and non-technical aspects of airway management. These include nasal endoscopy, virtual endoscopy, airway ultrasound, video endoscopes, supraglottic airways with enhanced protection against aspiration, hybrid devices, and the use of artificial intelligence and telemedicine, the utility of which has increased in recent times, thereby improving success with airway management and enhancing patient safety. There has been an increasing emphasis on peri-intubation oxygenation strategies to reduce complications in patients with a physiologically difficult airway. Recent guidelines for difficult airway management and preventing unrecognised oesophageal intubation are available. Large multicentre airway data collection helps us examine airway incidents, aetiology, and complications to expand our knowledge and give us insights for change in practice.

Airway management in a two‐year‐old child with a tongue tumor using video laryngoscope‐assisted flexible bronchoscopic nasotracheal intubation (hybrid technique)

“…While initially separate monitors had to be used for video laryngoscopy and flexible bronchoscopy, systems are now available that allow the video laryngoscope and bronchoscope to be displayed as a split image on the monitor 21 . However, the range of thin video bronchoscopes is very limited, so that in the case of pediatric patients, as in the case presented, two different monitor systems have to be used.…”

The current trend of emergency airway management: a clinical review

“…While an anatomically difficult airway is one in which obtaining a glottic view or passing an endotracheal tube is challenging, a physiologically difficult airway is one in which physiological derangements place the patient at a higher risk of cardiopulmonary collapse with ETI and conversion to positive pressure ventilation [16]. Physiologically difficult airways include those of critically ill patients with hypoxia, hypotension, metabolic acidosis, right heart failure, and neurological damage; however, healthy patients, pregnant women, obese people, and children are also included [16][17][18][19][20]. undergoing ETI, found at least one major adverse peri-intubation event in 45.2% of patients [21].…”

Prediction of the difficult airway by pre-operative ultrasound-based measurement of airway parameters: A prospective observational study

“…Ultrasonography is a simple, non-invasive technique used by anaesthesiologists perioperatively. [ 2 3 ] Point-of-care ultrasound has also been explored for its beneficial effect on airway management. [ 4 5 6 ] Pre-operative ultrasound measurement of the anterior neck soft-tissue thickness at various levels, in combination with the standard screening tests and assessment tools for difficult laryngoscopy, may enhance the prediction of difficult laryngoscopy.…”