SOP Der physiologisch schwierige Atemweg

Der „physiologisch schwierige Atemweg“ bezieht sich auf systemische intubationsassoziierte Probleme, die trotz technisch erfolgreicher Atemwegssicherung zu Komplikationen führen können. Diese SOP fokussiert auf patienten- und behandlungsbezogene Risiken, um durch gezielte Vorbereitung und Maßnahmen Komplikationen frühzeitig zu erkennen, zu minimieren und die Sicherheit sowie den Erfolg der Atemwegssicherung zu erhöhen.

Publication History

Article published online:
08 April 2025

• Literatur

• 1 Russotto V, Myatra SN, Laffey JG. et al. Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients From 29 Countries. JAMA 2021; 325: 1164-1172
• 2 Downing J, Yardi I, Ren C. et al. Prevalence of peri-intubation major adverse events among critically ill patients: A systematic review and meta analysis. Am J Emerg Med 2023; 71: 200-216
• 3 De Jong A, Rolle A, Pensier J. et al. First-attempt success is associated with fewer complications related to intubation in the intensive care unit. Intensive Care Med 2020; 46: 1278-1280
• 4 Hypes C, Sakles J, Joshi R. et al. Failure to achieve first attempt success at intubation using video laryngoscopy is associated with increased complications. Intern Emerg Med 2017; 12: 1235-1243
• 5 Mosier JM, Joshi R, Hypes C. et al. The Physiologically Difficult Airway. West J Emerg Med 2015; 16: 1109-1117
• 6 Mosier J. The Physiologically Difficult Airway and Management Considerations. Curr Anesthesiol Rep 2024; 14: 446-457
• 7 Fonseca D, Graça MI, Salgueirinho C. et al. Physiologically difficult airway: How to approach the difficulty beyond anatomy. Trends Anaesth Crit Care 2023; 48: 101212
• 8 Higgs A, McGrath BA, Goddard C. et al. DAS guidelines on the airway management of critically ill patients. Anaesthesia 2018; 73: 1035-1036
• 9 Apfelbaum JL, Hagberg CA, Connis RT. et al. 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway. Anesthesiology 2022; 136: 31-81
• 10 Kornas RL, Owyang CG, Sakles JC. et al. Evaluation and Management of the Physiologically Difficult Airway: Consensus Recommendations From Society for Airway Management. Anesth Analg 2021; 132: 395-405
• 11 Mallampati SR. Clinical sign to predict difficult tracheal intubation (hypothesis). Can Anaesth Soc J 1983; 30: 316-317
• 12 Reed MJ, Rennie LM, Dunn MJ. et al. Is the 'LEMON' method an easily applied emergency airway assessment tool?. Eur J Emerg Med 2004; 11: 154-157
• 13 Roth D, Pace NL, Lee A. et al. Bedside tests for predicting difficult airways: an abridged Cochrane diagnostic test accuracy systematic review. Anaesthesia 2019; 74: 915-928
• 14 De Jong A, Molinari N, Terzi N. et al. Early identification of patients at risk for difficult intubation in the intensive care unit: development and validation of the MACOCHA score in a multicenter cohort study. Am J Respir Crit Care Med 2013; 187: 832-839
• 15 Luedike P, Totzeck M, Rammos C. et al. The MACOCHA score is feasible to predict intubation failure of nonanesthesiologist intensive care unit trainees. J Crit Care 2015; 30: 876-880
• 16 Gibbs KW, Semler MW, Driver BE. et al. Noninvasive Ventilation for Preoxygenation during Emergency Intubation. N Engl J Med 2024; 390: 2165-2177
• 17 Russotto V, Tassistro E, Myatra SN. et al. Peri-intubation Cardiovascular Collapse in Patients Who Are Critically Ill: Insights from the INTUBE Study. Am J Respir Crit Care Med 2022; 206: 449-458
• 18 Hockstein MA, Haycock K, Wiepking M. et al. Transthoracic Right Heart Echocardiography for the Intensivist. J Intensive Care Med 2021; 36: 1098-1109