关键词: Airway Children Guidelines Management

Mesh : Administration, Topical Airway Extubation / methods Airway Management / methods standards Algorithms Child Child, Preschool Equipment Design France Humans Infant Intubation, Intratracheal / instrumentation methods Laryngoscopy / instrumentation methods Lidocaine / administration & dosage Neuromuscular Nondepolarizing Agents / administration & dosage Rapid Sequence Induction and Intubation Respiratory Tract Infections Video Recording / instrumentation methods

来  源:   DOI:10.1016/j.accpm.2019.02.004   PDF(Sci-hub)

Abstract:
To provide French guidelines about \"Airway management during paediatric anaesthesia\".
A consensus committee of 17 experts from the French Society of Anaesthesia and Intensive Care Medicine (Société Française d\'Anesthésie-Réanimation, SFAR) and the Association of French speaking paediatric anaesthesiologists and intensivists (Association Des Anesthésistes Réanimateurs Pédiatriques d\'Expression Francophone, ADARPEF) was convened. The entire process was conducted independently of any industry funding. The authors followed the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE®) system to assess the quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasised. Few recommendations were not graded.
The panel focused on 7 questions: 1) Supraglottic Airway devices 2) Cuffed endotracheal tubes 3) Videolaryngoscopes 4) Neuromuscular blocking agents 5) Rapid sequence induction 6) Airway device removal 7) Airway management in the child with recent or ongoing upper respiratory tract infection. Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles were generated. The analysis of the literature and the redaction of the recommendations were then conducted according to the GRADE® methodology.
The SFAR Guideline panel provides 17 statements on \"airway management during paediatric anaesthesia\". After two rounds of discussion and various amendments, a strong agreement was reached for 100% of the recommendations. Of these recommendations, 6 have a high level of evidence (Grade 1 ± ), 6 have a low level of evidence (Grade 2 ± ) and 5 are experts\' opinions. No recommendation could be provided for 3 questions.
Substantial agreement exists among experts regarding many strong recommendations for paediatric airway management.
摘要:
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