scholarly journals Nuevo sistema de predicción de dificultad en la ventilación a través de dispositivos supraglóticos

2019 ◽  
Vol 11 (1) ◽  
pp. 5
Author(s):  
Marta Vicente Orgaz ◽  
Raquel González Velasco ◽  
Antonio García Rueda ◽  
Concepción Rodríguez Bertos

El objetivo de este estudio fue proponer y validar un nuevo sistema de puntuación clínica para predecir la dificultad de ventilación a través de un dispositivo supraglótico (DSG). Los autores desarrollaron un score que se validó prospectivamente en 5532 pacientes. Se asignaron valores numéricos a cada uno de los 4 factores de riesgo que se identificaron: varón, mayor de 45 años, distancia tiromentoniana (DTM) corta y movilidad cervical limitada, y su suma compuso el score. El rango de dicho score va de 0 a 7 puntos. Un score de 4 o mayor se asocia a un riesgo incrementado de dificultad de ventilación a través de DSG. Nuestra conclusión es que el nuevo score para predicción de dificultad de ventilación a través de dispositivos supraglóticos es fácil de usar y podría ayudar en el plan de manejo de la VAD por los anestesiólogos.  ABSTRACT New prediction system for difficult ventilation through a supraglottic airway device. The aim of this study was to propose and validate a new clinical score to predict difficult ventilation through a supraglottic airway device. The authors developed a scoring system that was prospectively validated in 5532 patients. They assigned point values to each of the identified four risk factors: male, age >45 yr., short thyromental distance, and limited neck movement, their sum composing the score. The score ranged between 0 and 7 points. A score 4 or greater is associated with an increased risk of difficult ventilation through a supraglottic airway device. Our conclusion is that the new score for prediction of difficult ventilation through a supraglottic airway device is easy to use and could help anesthetists plan for difficult airway management.

2021 ◽  
Vol 9 ◽  
Author(s):  
Teiji Sawa ◽  
Atsushi Kainuma ◽  
Koichi Akiyama ◽  
Mao Kinoshita ◽  
Masayuki Shibasaki

Difficult airway management (DAM) in neonates and infants requires anesthesiologists and critical care clinicians to respond rapidly with appropriate evaluation of specific situations. Therefore, organizing information regarding DAM devices and device-oriented guidance for neonate and infant DAM treatment will help practitioners select the safest and most effective strategy. Based on DAM device information and reported literature, there are three modern options for DAM in neonates and infants that can be selected according to the anatomical difficulty and device-oriented strategy: (1) video laryngoscope (VLS), (2) supraglottic airway device (SAD), and (3) flexible fiberoptic scope (FOS). Some VLSs are equipped with small blades for infants. Advanced SADs have small sizes for infants, and some effectively function as conduits for endotracheal intubation. The smallest FOS has an outer diameter of 2.2 mm and enables intubation with endotracheal tubes with an inner diameter of 3.0 mm. DAM in neonates and infants can be improved by effectively selecting the appropriate device combination and ensuring that available providers have the necessary skills.


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