The physiologically difficult airway

Le résumé fourni par la source

Airway management in critically ill patients remains one of the highest-risk procedures in acute care medicine. Traditionally, airway difficulty has been defined primarily by anatomical factors that complicate visualization of the glottis or placement of an endotracheal tube. However, increasing evidence indicates that physiological instability plays a critical role in adverse events during tracheal intubation. The physiologically difficult airway refers to situations in which underlying respiratory, hemodynamic, or metabolic disturbances predispose patients to rapid clinical deterioration during induction of anesthesia and initiation of mechanical ventilation. Common scenarios include severe hypoxemia associated with acute respiratory distress syndrome or pneumonia, circulatory instability such as septic or cardiogenic shock, metabolic derangements including diabetic ketoacidosis, and right ventricular dysfunction related to pulmonary embolism or pulmonary hypertension. Recognition of these high-risk physiological states, together with appropriate optimization prior to intubation, is essential for reducing peri-intubation complications and improving outcomes. This article reviews current understanding of the physiologically difficult airway, highlights key high-risk conditions, and discusses evidence-based strategies aimed at optimizing oxygenation, maintaining hemodynamic stability, improving procedural success, and ensuring safe post-intubation management.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.