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The Physiologically Difficult Airway.

Jarrod M Mosier1, Raj Joshi1, Cameron Hypes1

  • 1University of Arizona, Department of Emergency Medicine, Tucson, Arizona; University of Arizona, Department of Medicine, Division of Pulmonary, Critical Care, Allergy and Sleep, Tucson, Arizona.

The Western Journal of Emergency Medicine
|January 14, 2016
PubMed
Summary
This summary is machine-generated.

Critically ill patients face physiologically difficult airways, increasing cardiovascular collapse risk during intubation. Emergency physicians must address hypoxemia, hypotension, acidosis, and right ventricular failure, irrespective of anatomic airway challenges.

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Area of Science:

  • Critical Care Medicine
  • Emergency Medicine
  • Anesthesiology

Background:

  • Airway management in critically ill patients traditionally focuses on anatomic predictors of difficult intubation.
  • This approach may overlook critical physiological factors that increase patient risk.

Purpose of the Study:

  • To describe the concept of the physiologically difficult airway.
  • To highlight four specific physiological derangements that complicate airway management.

Main Methods:

  • Review of existing literature and clinical concepts related to airway management in critical illness.
  • Identification and categorization of physiological states that constitute a difficult airway.

Main Results:

  • The physiologically difficult airway is defined by derangements increasing cardiovascular collapse risk during airway procedures.
  • Four key physiological challenges are identified: hypoxemia, hypotension, severe metabolic acidosis, and right ventricular failure.

Conclusions:

  • Physiological status is a critical determinant of airway management difficulty in critically ill patients.
  • Emergency physicians must consider these physiological factors alongside anatomic assessments for safe and effective airway management.