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2020 ; 34
(6
): 924-943
Nephropedia Template TP
gab.com Text
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English Wikipedia
Aligning difficult airway guidelines with the anesthetic COVID-19 guidelines to
develop a COVID-19 difficult airway strategy: a narrative review
#MMPMID32642840
Wong P
; Lim WY
J Anesth
2020[Dec]; 34
(6
): 924-943
PMID32642840
show ga
The coronavirus disease 2019 (COVID-19) pandemic is caused by a coronavirus that
is transmitted primarily via aerosol, droplets or direct contact. This may place
anesthetists at higher risk of infection due to their frequent involvement in
aerosol-generating airway interventions. Many anesthethetic COVID-19 guidelines
have emerged, whose underlying management principles include minimizing aerosol
contamination and protecting healthcare workers. These guidelines originate from
Australia and New Zealand, Canada, China, India, Italy, Korea, Singapore, the
United States and the United Kingdom. Hospitalized COVID-19 patients may require
airway interventions, and difficult tracheal intubation secondary to laryngeal
edema has been reported. Pre-pandemic difficult airway guidelines include those
from Canada, France, Germany, India, Japan, Scandinavia, the United States and
the United Kingdom. These difficult airway guidelines require modifications in
order to align with the principles of the anesthetic COVID-19 guidelines. In
turn, most of the anesthetic COVID-19 guidelines do not, or only briefly, discuss
an airway strategy after failed tracheal intubation. Our article identifies and
compares pre-pandemic difficult airway guidelines with the recent anesthetic
COVID-19 guidelines. We combine the principles from both sets of guidelines and
explain the necessary modifications to the airway guidelines, to form a failed
tracheal intubation airway strategy in the COVID-19 patient. Valuing, and a
greater understanding of, these differences and modifications may lead to greater
adherence to the new COVID-19 guidelines.