2008, Part 2, 63-70, DOI: 10.1007/978-88-470-0773-4_7

Best Method to Establish the Grade of Difficult Airway. Clinical Assessment, Techniques and Procedures in Critical Care and ICU

F. Petrini, L. Moggia and G. Merli

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Abstract

Due to advances in training, technology and guidelines implementation, elective airway management within the setting of the Operating Room (OR) can be associated with very low complication rates [1]. There has been a heightened awareness and a steady rise in the amount of literature published on the prediction of difficult airways for anaesthesia purposes. Unfortunately none of the suggested methods provide satisfactory results in terms of sensitivity and specificity: at least for now, reliable prediction of difficult airway management (DAM) is likely to remain a decision-making process based on clinical judgment, and this is particularly true in emergency situations and critical illness [2]. Furthermore, the epidemiology of DAM varies according to the different definitions used and the population studied in the large amount of literature on the subject [3]. Complication rates in the Intensive Care Unit (ICU) environment are also much higher due to the inability, in the majority of cases, to perform a thorough evaluation of the patient’s anatomy prior to airway instrumentation.

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