Advances and Controversies in Perioperative Airway Management
1Charles University, Prague, Czech Republic
2University of Iowa, Iowa City, USA
3University of Kocaeli, Kocaeli, Turkey
4Antrim Area Hospital, Antrim, UK
5Tokyo Women’s Medical University, Tokyo, Japan
Advances and Controversies in Perioperative Airway Management
Description
Securing and maintaining a patent airway is one of the cornerstones of safe perioperative management. The process begins with preoperative airway assessment. New systems for preoperative airway evaluation have been developed and validated during the last two decades with a focus placed on imaging methods—magnetic resonance imaging (MRI), ultrasound, and nasal endoscopy. Advances in equipment are mostly related to two categories—the improvement of laryngoscopes and the development of new extraglottic airway devices. Videolaryngoscopes allow improved visualisation and intubation of deviated larynx and also help in patients with restricted mouth opening or limited mobility of the cervical spine. Recent efforts have been focused on making these devices more portable.
Development of new extraglottic airway devices has been driven by efforts to decrease complications associated with tracheal intubation and to invent a device providing high protection against aspiration of gastric contents. Such devices should possess high oropharyngeal seal pressures and allow easy insertion even in the hands of inexperienced users. Other areas of development of extraglottic airway devices focus on their use in difficult airway management or in nonstandard indications. Difficult or failed scenarios in perioperative airway management are relatively rare, being much more frequent in prehospital medicine or in emergency departments. Therefore, current guidelines, algorithms, and recommendations for clinical pratice are often not based on evidence but rather on expert opinions, consensus, and anecdotal reports. Future airway research should focus on setting up large multicentre studies adequately powered to evaluate the incidence of rare complications, such as aspiration of gastric contents or damage to anatomical structures. More light should be also shone on the real role of simulation studies on manikins and their extrapolation to human medicine.
We would like to invite investigators to submit original research articles, systematic reviews, meta-analyses, and focused review articles that can contribute to solving the problems of perioperative airway management.
Potential topics include, but are not limited to:
- Preoperative airway assessment
- Use of ultrasound and other imaging methods in airway assessment and airway management
- Novel technologies in laryngoscopy
- Supraglottic airway devices in borderline indications—laparoscopic surgeries, obesity, and other positions than supine
- Supraglottic airways in difficult airway management
- Risks and complications of airway management techniques
- Current state and future of airway management research
- Role of simulation in airway management
- Airway management training and application of guidelines