Management of upper airway obstruction: intubation vs tracheotomy

Management of the obstructed upper airway may be very challenging. It requires careful clinical evaluation as well as supportive laboratory data and physiologic monitoring. A team approach is essential. This paper is an overall review of the subject of airway control intended to guide health care providers dealing with such patients. Various options of intervention including endotracheal intubation, tracheotomy and transtracheal jet ventilation are discussed. The indications, advantages, disadvantages and potential complications of each of these methods are detailed. Recent advances in this field are described such as new tube material and technology, non-invasive physiologic monitoring (oxygen saturation measurements) and modifications of the surgical techniques.