Airway Management in Critical Illness: An Update

J Aaron Scott; Stephen O Heard; Maksim Zayaruzny; J Matthias Walz

doi:10.1016/j.chest.2019.10.026

Airway Management in Critical Illness: An Update

Chest. 2020 Apr;157(4):877-887. doi: 10.1016/j.chest.2019.10.026. Epub 2019 Nov 9.

Authors

J Aaron Scott¹, Stephen O Heard², Maksim Zayaruzny², J Matthias Walz²

Affiliations

¹ Division of Critical Care Medicine, Department of Anesthesiology and Perioperative Medicine, University of Massachusetts Memorial Medical Center, Worcester, MA. Electronic address: [email protected].
² Division of Critical Care Medicine, Department of Anesthesiology and Perioperative Medicine, University of Massachusetts Memorial Medical Center, Worcester, MA.

PMID: 31711987
DOI: 10.1016/j.chest.2019.10.026

Abstract

Expertise in airway management is a vital skill for any provider caring for critically ill patients. A growing body of literature has identified the stark difference in periprocedural outcomes of elective intubation in the operating room when compared with emergency intubation in the ICU. A number of strategies to reduce the morbidity and mortality associated with airway management in the critically ill have been described. In this review, we provide an updated framework for airway assessment before direct laryngoscopy and video laryngoscopy, and use of newer pharmacologic agents; comment on current concepts in tracheal intubation in the ICU; and address human factors around critical decision-making during ICU airway management.

Keywords: ICU intubation; airway management; difficult airway.

Publication types

Review

MeSH terms

Airway Management* / methods
Airway Management* / trends
Critical Illness / therapy*
Emergency Medical Services*
Humans
Intubation, Intratracheal / methods
Laryngoscopy / methods