Bibliografia 2

         BIBLIOGRAFIA

1) Evolution of the Extraglottic Airway: A Review of Its History, Applications, and Practical Tips for Success

Michael R. Hernandez, MD,* P. Allan Klock, Jr., MD,* and Adranik Ovassapian, MD*†

February 2012 • Volume 114 • Number 2

www.anesthesia-analgesia.org 365 Review Article

2) Supraglottic Airways For Pediatric Patients: An Overview

NARASIMHAN SIM JAGANNATHAN, MD

Department of Pediatric Anesthesia
Ann & Robert H. Lurie Children’s Hospital of Chicago Director of Anesthesia Research
Associate Professor of Anesthesiology
Northwestern University’s Feinberg School of Medicine Chicago, Illinois

JOHN EDEM FIADJOE, MD

Assistant Professor of Anesthesiology and Critical Care Perelman School of Medicine at the University of Pennsylvania and The Children’s Hospital of Philadelphia
Philadelphia, Pennsylvania

PRINTER-FRIENDLY VERSION AVAILABLE AT ANESTHESIOLOGYNEWS.COM

3) Difficult Airway Society Guidelines  DAS

      http://www.das.uk.com

4) Unanticipated Difficult Airway Management in the Prehospital Emergency Setting

Prospective Validation of an Algorithm

Xavier Combes, M.D.,* Patricia Jabre, M.D., Ph.D.,† Alain Margenet, M.D.,* Jean Claude Merle, M.D.,* Bertrand Leroux, M.D.,* Michel Dru, M.D.,* Eric Lecarpentier, M.D.,‡ Gilles Dhonneur, M.D., Ph.D.§

ABSTRACT

Background: Difficult intubation management algorithms have proven efficacy in operating rooms but have rarely been assessed in a prehospital emergency setting. We undertook a prospective evaluation of a simple prehospital difficult intu- bation algorithm.

Methods: All of our prehospital emergency physicians and nurse anesthetists were asked to adhere to a simple algorithm in all cases of impossible laryngoscope-assisted tracheal intu- bation. They received a short refresher course and training in the use of the gum elastic bougie (GEB) and the intubating laryngeal mask airway (ILMA), which were techniques to be used as a first and a second step, respectively. In cases of difficult ventilation with arterial desaturation, IMLA was to be used first. Cricothyroidotomy was the ultimate rescue technique when ventilation through ILMA failed. Patient characteristics, adherence to the algorithm, management ef- ficacy, and early complications were recorded (August 2005– December 2009).

Copyright © 2010, the American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins.

Anesthesiology 2011; 114: 105–10

Results: An alternative technique to secure the airway was needed in 160 of 2,674 (6%) patients undergoing intubation. Three instances of non adherence to the algorithm were recorded. GEB was used first in 152 patients and was suc- cessful in 115. ILMA was used first in 8 patients and second in the 37 GEB-assisted intubation failures. Forty-five pa- tients were successfully mask-ventilated, and 42 were blindly intubated before reaching the hospital. Cricothyroidotomy was used successfully in a patient with severe upper airway obstruction as a result of pharyngeal neoplasia. Early intuba- tion-related complications occurred in 52% difficult cases. Conclusion: Adherence to a simple algorithm using GEB, ILMA, and cricothyroidotomy solved all difficult intubation cases occurring in a prehospital emergency setting.