Airway management in critically sick in intensive care

Abstract

In critically ill patients in Intensive Care Unit (ICU), patency of airway and management
of difficult airway are of utmost importance. The incidence of difficult intubation may
be 10% to 22% depending on the various factors in patient as well as availability of
equipment facilities. As compared to the regular surgery in operation theatre, the
management of airway in critically ill patients is considerably different and more
challenging. The physiological reserve and co-morbidities are more common in critically
ill patients. In ICU, recent techniques of airway management must be considered and
practiced, such as videolaryngoscope (VLS), fiberoptic bronchoscope and supraglottic
devices. The success for airway management would be greater if airway expert, the
required devices and an adequate protocol are available. The outcome of managing
airway would be enhanced if best use of available airway devices in a particular hospital
setup since every instrument may not be available. The standard guidelines for difficult
airway and the protocol of individual hospital may reduce the complications; hence
must be followed. The availability of difficult airway cart and capnograph is a must. The
indications and timing of surgical airway must be clear to the airway team. The Training
courses for the staff in ICU should be held regularly to apprise them of advancement
in airway management. The best use of available airway equipment should be made in
critically ill patients. At least, one airway expert must be accessible in ICU at any given
time.

Received: 12 Sep 2018
Reviewed: 5 Oct 2018
Accepted: 10 Oct 2018

Citation: Malhotra SK, Gandhi K. Airway management in critically sick in intensive care. Anaesth Pain & Intensive Care 2018;22 Suppl 1:S21-S28