Ultrasonography for Airway Assessment and Management

Abstract

irway management is essential in every medical specialty. Maintaining a patent airway is essential for adequate oxygenation and ventilation and failure to do so; even for a brief period of time, can be life threatening. Respiratory events are the most common anesthetic-related injuries, following dental damage. The three main causes of anesthetic respiratory-related injuries are inadequate ventilation, esophageal intubation and difficult tracheal intubation. Difficult tracheal intubation accounts for 17% of the respiratory-related injuries and results in significant morbidity and mortality. In fact, up to 28% of all anesthesia-related deaths are secondary to the inability to mask ventilate or intubate. The term ‘airway’ in its day-to-day usage refers to the upper airway which may be defined as the extrapulmonary air passages, consisting of the nasal and oral cavities, pharynx, larynx, trachea and large bronchi. ‘Difficult airway’ is one in which there is a problem in establishing or maintaining gas exchange via a mask, an artificial airway or both. Recognizing before anesthesia, the potential for a difficult airway (DA) in designated ‘difficult airway clinics’ allows time for optimal preparation, proper selection of equipment and technique and participation of personnel experienced in DA management. The difficulty of achieving a patent airway varies with