Evaluation, Preparation, Decision, and Oxygenation: Interpretation on 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway
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摘要: 困难气道是麻醉管理中常见的问题之一, 与麻醉安全和质量密切相关。规范困难气道患者的管理, 是麻醉工作的重要内容。多个国际学术组织先后发布了多部临床实践指南或专家共识, 使医务人员对困难气道的处理能力不断提高。2022年1月, 《2022年美国麻醉医师协会困难气道管理实践指南》发布, 从困难气道的评估、准备、管理等多个方面更新了内容。本文将从麻醉学角度, 对此版指南的重点内容进行详细解读, 以期为困难气道的规范化管理提供借鉴和参考。Abstract: A difficult airway is one of the common clinical problems in anesthesia management, which is closely related to the safety and quality of anesthesia. Standardizing the management of patients with difficult airways is an important part of anesthesia. As many international academic organizations have successively issued a number of practice guidelines or expert consensuses, the ability to deal with difficult airways by medical staff is constantly improving. In January 2022, the 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway was released, which updated the contents of the evaluation, preparation, management and other aspects of difficult airways. With a view to providing clinical reference for the standardized management of difficult airways, this paper makes a detailed interpretation on the key points of the guideline from the perspective of anesthesiology.
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Key words:
- difficult airway /
- guideline /
- anesthesia /
- interpretation
作者贡献:吴觉伦负责查阅文献,撰写初稿;申乐负责修订论文。利益冲突:所有作者均声明不存在利益冲突 -
图 1 成人患者困难气道处理流程[1]
图 2 儿童患者困难气道处理流程[1]
ECMO: 体外膜肺氧合器
表 1 气道管理设备清单[1]
设备名称 设备名称 简易呼吸器 用于紧急有创气道管理的设备 吸引器及合适的连接管 不同型号的声门上气道 不同型号的面罩 水溶性医用润滑剂 口咽和鼻咽通气道 鼻导管与氧气面罩 不同种类及型号的喉镜片及喉镜柄 可视喉镜 不同种类及型号的气管插管 满足ASA标准的监护设备 针对成人患者的气管插管探条 麻醉诱导、维持及抢救药物 气管导管导丝 注:该清单为2022版指南推荐的麻醉车内应准备物品最低要求,此外麻醉车内物品可根据操作者的特殊需要、偏好及擅长的技能进行定制;ASA: 美国麻醉医师协会 -
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