RESEARCH ARTICLE
Extubation of the Difficult Airway: An Algorithmic Approach
C. Voscopoulos1, *, L. Jalota2, F. L. Kirk3, A. Saxena4, M. Lema3, C. Apfel2, J. Antoine2
Article Information
Identifiers and Pagination:
Year: 2012Volume: 6
First Page: 1
Last Page: 8
Publisher ID: TOATJ-6-1
DOI: 10.2174/1874321801206010001
Article History:
Received Date: 05/12/2011Revision Received Date: 17/01/2012
Acceptance Date: 25/01/2012
Electronic publication date: 24/2/2012
Collection year: 2012
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
The difficult airway has been defined as a “clinical situation in which a conventionally trained anesthesiologist experiences difficulty with mask ventilation of the upper airway, tracheal intubation, or both.” Given the potentially lifethreatening consequences, the American Society of Anesthesiology has developed an airway algorithm that focuses on establishing an airway, generally for the induction of anesthesia. However, there is no algorithm on how to safely transition from an established airway back to the normal, natural airway. Up to 0.19 percent of patients can require reintubation in the post anesthesia recovery unit, with the known difficult airway at greater risk in these settings for failed reintubation. Because of this, there has been recognition of the need for guidelines in the form of an algorithm to deal with extubation in these patients. To fill this current need, we propose the following difficult to intubate patient extubation algorithm for use in the operating room setting.