PDF(Pubmed)
Abstract：
Airway management in both acute and reconstructive burn patients can be a major challenge for evaluation, intubation, and securing the airway in the setting of altered airway structure. Airway evaluation in both acute and reconstructive patients includes examination for evidence of laryngeal and supraglottic edema and structural changes due to trauma and/or scarring that will impact the successful approach to acquiring an airway for surgical procedures and medical recovery. The approach to acquiring a successful airway is rarely standard laryngoscopy and often requires fiberoptic bronchoscopy and a variety of airway manipulation techniques. Tracheostomy should be reserved for those with classic requirements of ventilatory and/or mechanical failure or severe upper airway burns. Even securing an airway for surgical procedures, especially with patients suffering injuries involving the head and neck, can be nonstandard and requires creative and flexible approaches to be successful. After much trial and error over the past 30 years in a large burn center, our multidisciplinary team has learned many valuable lessons. This review will focus on our current approach to safe airway management in acute and reconstructive burn patients.
摘要：
急性和重建烧伤患者的气道管理可能是评估的主要挑战，插管,并在气道结构改变的情况下固定气道。急性和重建患者的气道评估包括检查喉和声门上水肿的证据以及由于创伤和/或疤痕形成而引起的结构变化，这将影响成功获得用于外科手术和医疗恢复的气道的方法。获得成功气道的方法很少是标准喉镜检查，通常需要纤维支气管镜检查和各种气道操作技术。气管造口术应保留给那些有经典要求的通气和/或机械故障或严重的上呼吸道烧伤。即使是固定手术的气道，尤其是头部和颈部受伤的患者，可能是非标准的，需要创造性和灵活的方法才能成功。经过过去30年在大型烧伤中心的反复试验，我们的多学科团队吸取了许多宝贵的教训。本文将重点介绍我们当前在急性和重建烧伤患者中安全气道管理的方法。
