Editors: Eugenio Daniel Martinez-Hurtado, Mariscal Flores María Luisa

Series Title: Recent Advances in Anesthesiology

An Update on Airway Management

Volume 3

eBook: US $79 Special Offer (PDF + Printed Copy): US $134.5
Printed Copy: US $95
Library License: US $316
ISSN: 2589-9384 (Print)
ISSN: 2589-9392 (Online)
ISBN: 978-981-14-3237-8 (Print)
ISBN: 978-981-14-3238-5 (Online)
Year of Publication: 2020
DOI: 10.2174/97898114323851200301

Introduction

All anaesthesiologists know that the highest morbidity and mortality associated with anaesthesia are related to the airway management of our patients. This area represents one of the basic pillars of the specialty, and the Difficult Airway is the undisputed protagonist in all the congresses and the subject of numerous publications periodically.

Airway management has been changing over the years. Progressively, the evaluation and prediction of the possible difficulty in ventilation, oxygenation and intubation in the preoperative assessment have been standardized, while numerous devices have appeared that facilitate the way to approach the handling of the Difficult Airway.

It is no longer just about knowing how to use the fiberoptic bronchoscope, although this is still the main tool for managing the Difficult Airway. We are also obliged to know and use a wide range of new devices, as well as the indications and peculiarities of each of them.

Unfortunately, this great quantity of available devices means that many times we do not know them well, nor do we differentiate them. And, therefore, in many occasions, we do not use them in an adequate way. It does not consist in having and using all, but in mastering the use of those we have and acquiring experience with them so that they are effective when a Difficult Airway situation arises.

This book “Recent Advances in Anaesthesiology Vol. 3 – An Update on Airway Management” is an update of those topics that have had an important development in recent years in airway management. We have tried to approach the latest developments in this field with a simple, easy and direct reading, which helps in professionals' daily work.

We intend to reach a multitude of colleagues from all medical areas who have to manage their patients' airways: anaesthesiologists, intensivists, intra- and extra-hospital emergency physicians, pneumologists, ENT surgeons... who we believe could be of support for your work.

We also believe that it may be of interest to residents in training, as a method of updating and updating a subject that is basic and without which, almost all others are impossible to carry out.

Foreword

This book entitled “Recent Advances in Anesthesiology Vol. 3 – An Update on Airway Management” is an excellent tool for learning about Airway management, which remains one of the pillars of the anaesthesiology and critical care in a variety of "scheduled, urgent or emergent situations. The scope of action can be in hospital but also extrahospital, with all the connotations of difficulty that the latter usually possess.

Unquestionably, the advances in devices to improve our ability to control the airway have been momentous in recent decades, particularly through the incorporation of different devices with built-in optics. These include videolaryngoscopes, with or without a channel, that have irrefutably revolutionized our usual clinical practice, specifically useful for the unforeseen difficult airway (DA), but also for some cases of anticipated DA.

This means that in the last Difficult Airway Society (DAS) guidelines, this device is already within Plan A of the algorithm. The inclusion of fiberscope in our daily clinical practice has also been very helpful as instruments that all specialists who need to manage the airway should know and be trained in its proper use. Furthermore, we must not forget the fundamental importance of the supraglottic devices that are described in detail in this work, or the intubation guidelines, stylets, tube interchanges and guide for safe extubation by stages, insomuch as extubation is one of the most dangerous moments where we must anticipate all possible secure clinical alternatives.

Of course, the optimal management of DA requires a prior study of the patient to guide the most appropriate technique in each patient, which has been fundamental to improve the quality and safety of these procedures. However, the predictors are not always reliable, so more studies should be conducted to improve the prediction of DA.

Training in airway management is perhaps the most important aspect from my modest point of view, so this work can contribute a lot to update this matter and specify how to act with the new guidelines endorsed by experts such as the participating authors in the same. Undoubtedly, the learning of airway management through clinical simulation is essential for any professional who requires training in this type of technique.

In summary, I sincerely believe that this work will contribute to a better knowledge of safe clinical practice and quality control of the airway in all types of clinical situations.

Manuel Granell Gil
Profesor Asociado de Anestesiología, Universidad de Valencia,
Médico Jefe de Sección de Anestesiología,
CHGUV. Vocal de Torácica (SEDAR) y del Thoracic SubCommittee (EACTA),
Valencia
Spain

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