The physiologically difficult airway

Jarrod M. Mosier, Raj Joshi, Cameron Hypes, Garrett Pacheco, Terence Valenzuela, John C. Sakles

Research output: Contribution to journalReview articlepeer-review

58 Scopus citations

Abstract

Airway management in critically ill patients involves the identification and management of the potentially difficult airway in order to avoid untoward complications. This focus on difficult airway management has traditionally referred to identifying anatomic characteristics of the patient that make either visualizing the glottic opening or placement of the tracheal tube through the vocal cords difficult. This paper will describe the physiologically difficult airway, in which physiologic derangements of the patient increase the risk of cardiovascular collapse from airway management. The four physiologically difficult airways described include hypoxemia, hypotension, severe metabolic acidosis, and right ventricular failure. The emergency physician should account for these physiologic derangements with airway management in critically ill patients regardless of the predicted anatomic difficulty of the intubation.

Original languageEnglish (US)
Pages (from-to)1109-1117
Number of pages9
JournalWestern Journal of Emergency Medicine
Volume16
Issue number7
DOIs
StatePublished - 2015

Keywords

  • Acute respiratory failure
  • Airway management
  • Hypercapnea
  • Hypoxemia
  • Intubation
  • Mechanical ventilation
  • Metabolic acidosis
  • Right ventricular failure

ASJC Scopus subject areas

  • Emergency Medicine

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