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Procedural difficulties during successful intubation in octogenarians: A prospective observational study.
1Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, Estados Unidos.
Revista Espanola De Anestesiologia Y Reanimacion
|April 4, 2017
Summary
Airway management in octogenarians presents challenges. While combined intubation, ventilation, and oxygenation difficulties were rare, bag mask ventilation was often laborious, leading to desaturation in elderly patients.
Area of Science:
- Anesthesiology and Critical Care Medicine
- Geriatric Medicine
- Airway Management
Background:
- Octogenarians experience age-related physiological changes that complicate airway management.
- Difficulties in intubation, bag-mask ventilation, and oxygenation can lead to adverse events like desaturation and aspiration in older adults.
Purpose of the Study:
- To examine the process of airway management in octogenarians.
- To identify deviations and delays in intubation tasks and associated complications.
Main Methods:
- Prospective observational study of octogenarians (≥80 years) with predicted difficult airways.
- Data collected included demographics, airway indices, and specific events: intubation attempts (INT), ventilation laboriousness (VEN), and oxygenation complications (OXY).
- Analysis focused on the incidence of problematic intubation, laborious ventilation, and desaturation.
Main Results:
- Of 41 patients, 7.3% experienced all three difficulties (INT, VEN, OXY).
- Individual difficulties were more common: 48.8% had laborious ventilation (VEN), and 34.1% experienced oxygenation complications (OXY).
- Only 19.5% encountered problematic intubation (INT).
Conclusions:
- Combined airway management difficulties (INT-VEN-OXY) are infrequent in octogenarians.
- Bag-mask ventilation is frequently laborious and associated with a high incidence of desaturation in this population.
- Alternative airway devices, techniques, and specific protocols are recommended for elderly patients.
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