Airway decision making in major head and neck surgery: Irish multicenter, multidisciplinary recommendations.

Autor: Cleere EF; Department of Otolaryngology - Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland., Read C; Department of Anaesthesia and Critical Care, Beaumont Hospital, Dublin, Ireland., Prunty S; Department of Otolaryngology - Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland., Duggan E; Department of Anaesthesia and Critical Care, Beaumont Hospital, Dublin, Ireland., O'Rourke J; Department of Anaesthesia and Critical Care, Beaumont Hospital, Dublin, Ireland., Moore M; Department of Anaesthesia and Critical Care, Beaumont Hospital, Dublin, Ireland., Vasquez P; Department of Physiotherapy, Beaumont Hospital, Dublin, Ireland., Young O; Department of Otolaryngology - Head and Neck Surgery, Galway University Hospital, Galway, Ireland., Subramaniam T; Department of Otolaryngology - Head and Neck Surgery, Galway University Hospital, Galway, Ireland., Skinner L; Department of Otolaryngology - Head and Neck Surgery, University Hospital Waterford, Waterford, Ireland., Moran T; Department of Otolaryngology - Head and Neck Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.; Department of Otolaryngology - Head and Neck Surgery, St Vincent's University Hospital, Dublin, Ireland., O'Duffy F; Department of Otolaryngology - Head and Neck Surgery, Mater Misericordiae University Hospital, Dublin, Ireland.; Department of Otolaryngology - Head and Neck Surgery, St Vincent's University Hospital, Dublin, Ireland., Hennessy A; Department of Anaesthesiology, South Infirmary Victoria University Hospital, Cork, Ireland., Dias A; Department of Otolaryngology - Head and Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland., Sheahan P; Department of Otolaryngology - Head and Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland.; ENTO Research Unit, College of Medicine and Health, University College Cork, Cork, Ireland., Fitzgerald CWR; Department of Otolaryngology - Head and Neck Surgery, St James's Hospital, Dublin, Ireland., Kinsella J; Department of Otolaryngology - Head and Neck Surgery, St James's Hospital, Dublin, Ireland., Lennon P; Department of Otolaryngology - Head and Neck Surgery, St James's Hospital, Dublin, Ireland., Timon CVI; Department of Otolaryngology - Head and Neck Surgery, St James's Hospital, Dublin, Ireland., Woods RSR; Department of Otolaryngology - Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland., Shine N; Department of Otolaryngology - Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland., Curley GF; Department of Anaesthesia and Critical Care, Beaumont Hospital, Dublin, Ireland.; Department of Anaesthesia and Critical Care, Royal College of Surgeons in Ireland, Dublin, Ireland., O'Neill JP; Department of Otolaryngology - Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland.; Department of Otolaryngology - Head and Neck Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland.
Jazyk: angličtina
Zdroj: Head & neck [Head Neck] 2024 Sep; Vol. 46 (9), pp. 2363-2374. Date of Electronic Publication: 2024 Jul 10.
DOI: 10.1002/hed.27868
Abstrakt: Major head and neck surgery poses a threat to perioperative airway patency. Adverse airway events are associated with significant morbidity, potentially leading to hypoxic brain injury and even death. Following a review of the literature, recommendations regarding airway management in head and neck surgery were developed with multicenter, multidisciplinary agreement among all Irish head and neck units. Immediate extubation is appropriate in many cases where there is a low risk of adverse airway events. Where a prolonged definitive airway is required, elective tracheostomy provides increased airway security postoperatively while delayed extubation may be appropriate in select cases to reduce postoperative morbidity. Local institutional protocols should be developed to care for a tracheostomy once inserted. We provide guidance on decision making surrounding airway management at time of head and neck surgery. All decisions should be agreed between the operating, anesthetic, and critical care teams.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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