Dr. Ehab AbouAlazayem Abdelsalam Mohamed Shalaby
Tracheal intubation in critically ill patients is linked to significant consequences, primarily include cardiovascular break down and severe hypoxemia. This narrative review provides an updated overview of strategies that try to reduce these problems. MACOCHA is a straightforward scoring system used to identify patients in the critical care unit (ICU) at a high risk of experiencing difficulties during intubation. The combination of inspiratory assistance and strong end-expiratory pressure should continue to be the established approach for preoxygenation in patients with low levels of oxygen in their blood. Apneic oxygenation, utilizing high-flow nasal oxygen, can be employed as an adjunctive measure to mitigate the risk of worsening hypoxemia throughout tracheal intubation. Face mask ventilation with rapid sequence induction can be employed as a measure to avoid hypoxemia in specific patients who do not have a significant likelihood of aspiration. Prior to, during, and following the intubation procedure, it is crucial to engage in hemodynamic optimization and management. All of the components can be consolidated into a single package. Every intensive care unit (ICU) should implement an airway management algorithm that is customized to the requirements, circumstances, and proficiency of each practitioner. Experienced operators should utilize video laryngoscopes.
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