Difficult airway management in the intensive care unit: practical guidelines

Area of Science:

• Critical Care Medicine
• Anesthesiology
• Emergency Medicine

Background:

• Difficult airway management is a critical skill in intensive care.
• Intubation is infrequent but often challenging in intensive care unit (ICU) patients.
• Inadequate airway management has severe consequences for patients and staff.

Purpose of the Study:

• To review the literature on difficult airway management.
• To apply existing knowledge to the intensive care unit (ICU) setting.
• To propose guidelines for ICU difficult airway management.

Main Methods:

• Literature search of Medline and Pubmed databases (1975-2002).
• Assessment of publications for relevance to the ICU.
• Synthesis of findings to inform ICU practice.

Main Results:

• Difficult airway management principles are applicable to the ICU.
• Most literature originates from anesthesiology and emergency medicine.
• Guidelines are proposed to aid ICU clinicians.

Conclusions:

• Core principles of difficult airway management apply universally.
• Developing a personalized difficult airway algorithm is vital.
• Early assistance and backup plans are essential in the ICU.