Need for emergency surgical airway reduced by a comprehensive difficult airway program

Lauren C. Berkow, Robert S Greenberg, Kristin H. Kan, Elizabeth Ann Colantuoni, Lynette J Mark, Paul W. Flint, Marco Corridore, Nasir Islam Bhatti, Eugenie S. Heitmiller

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Inability to intubate and ventilate patients with respiratory failure is associated with significant morbidity and mortality. A patient is considered to have a difficult airway if an anesthesiologist or other health care provider experienced in airway management is unable to ventilate the patient's lungs using bag-mask ventilation and/or is unable to intubate the trachea using direct laryngoscopy. METHODS: We performed a retrospective review of a departmental database to determine whether a comprehensive program to manage difficult airways was associated with a reduced need to secure the airway surgically via cricothyrotomy or tracheostomy. The annual number of unplanned, emergency surgical airway procedures for inability to intubate and ventilate reported for the 4 yr before the program (January 1992 through December 1995) was compared with the annual number reported for the 11 yr after the program was initiated (January 1996 through December 2006). RESULTS: The number of emergency surgical airways decreased from 6.5 ± 0.5 per year for 4 yr before program initiation to 2.2 ± 0.89 per year for the 11-yr period after program initiation (P <0.0001). During the 4-yr period from January 1992 through December 1995, 26 surgical airways were reported, whereas only 24 surgical airways were performed in the subsequent 11-yr period (January 1996 through December 2006). CONCLUSIONS: A comprehensive difficult airway program was associated with a reduction in the number of emergency surgical airway procedures performed for the inability of an anesthesiologist to intubate and ventilate, a reduction that was sustained over an 11-yr period. This decrease occurred despite an increase in the number of patients reported to have a difficult airway and an overall increase in the total number of patients receiving anesthesia per year.

Original languageEnglish (US)
Pages (from-to)1860-1869
Number of pages10
JournalAnesthesia and Analgesia
Volume109
Issue number6
DOIs
StatePublished - Dec 2009

Fingerprint

Emergencies
Laryngoscopy
Airway Management
Tracheostomy
Masks
Trachea
Respiratory Insufficiency
Health Personnel
Anesthesia
Databases
Morbidity
Lung
Mortality
Anesthesiologists

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Need for emergency surgical airway reduced by a comprehensive difficult airway program. / Berkow, Lauren C.; Greenberg, Robert S; Kan, Kristin H.; Colantuoni, Elizabeth Ann; Mark, Lynette J; Flint, Paul W.; Corridore, Marco; Bhatti, Nasir Islam; Heitmiller, Eugenie S.

In: Anesthesia and Analgesia, Vol. 109, No. 6, 12.2009, p. 1860-1869.

Research output: Contribution to journalArticle

Berkow, Lauren C. ; Greenberg, Robert S ; Kan, Kristin H. ; Colantuoni, Elizabeth Ann ; Mark, Lynette J ; Flint, Paul W. ; Corridore, Marco ; Bhatti, Nasir Islam ; Heitmiller, Eugenie S. / Need for emergency surgical airway reduced by a comprehensive difficult airway program. In: Anesthesia and Analgesia. 2009 ; Vol. 109, No. 6. pp. 1860-1869.
@article{c9516df40b2c4acba6a0bf0e8f6580f2,
title = "Need for emergency surgical airway reduced by a comprehensive difficult airway program",
abstract = "BACKGROUND: Inability to intubate and ventilate patients with respiratory failure is associated with significant morbidity and mortality. A patient is considered to have a difficult airway if an anesthesiologist or other health care provider experienced in airway management is unable to ventilate the patient's lungs using bag-mask ventilation and/or is unable to intubate the trachea using direct laryngoscopy. METHODS: We performed a retrospective review of a departmental database to determine whether a comprehensive program to manage difficult airways was associated with a reduced need to secure the airway surgically via cricothyrotomy or tracheostomy. The annual number of unplanned, emergency surgical airway procedures for inability to intubate and ventilate reported for the 4 yr before the program (January 1992 through December 1995) was compared with the annual number reported for the 11 yr after the program was initiated (January 1996 through December 2006). RESULTS: The number of emergency surgical airways decreased from 6.5 ± 0.5 per year for 4 yr before program initiation to 2.2 ± 0.89 per year for the 11-yr period after program initiation (P <0.0001). During the 4-yr period from January 1992 through December 1995, 26 surgical airways were reported, whereas only 24 surgical airways were performed in the subsequent 11-yr period (January 1996 through December 2006). CONCLUSIONS: A comprehensive difficult airway program was associated with a reduction in the number of emergency surgical airway procedures performed for the inability of an anesthesiologist to intubate and ventilate, a reduction that was sustained over an 11-yr period. This decrease occurred despite an increase in the number of patients reported to have a difficult airway and an overall increase in the total number of patients receiving anesthesia per year.",
author = "Berkow, {Lauren C.} and Greenberg, {Robert S} and Kan, {Kristin H.} and Colantuoni, {Elizabeth Ann} and Mark, {Lynette J} and Flint, {Paul W.} and Marco Corridore and Bhatti, {Nasir Islam} and Heitmiller, {Eugenie S.}",
year = "2009",
month = "12",
doi = "10.1213/ane.0b013e3181b2531a",
language = "English (US)",
volume = "109",
pages = "1860--1869",
journal = "Anesthesia and Analgesia",
issn = "0003-2999",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Need for emergency surgical airway reduced by a comprehensive difficult airway program

AU - Berkow, Lauren C.

AU - Greenberg, Robert S

AU - Kan, Kristin H.

AU - Colantuoni, Elizabeth Ann

AU - Mark, Lynette J

AU - Flint, Paul W.

AU - Corridore, Marco

AU - Bhatti, Nasir Islam

AU - Heitmiller, Eugenie S.

PY - 2009/12

Y1 - 2009/12

N2 - BACKGROUND: Inability to intubate and ventilate patients with respiratory failure is associated with significant morbidity and mortality. A patient is considered to have a difficult airway if an anesthesiologist or other health care provider experienced in airway management is unable to ventilate the patient's lungs using bag-mask ventilation and/or is unable to intubate the trachea using direct laryngoscopy. METHODS: We performed a retrospective review of a departmental database to determine whether a comprehensive program to manage difficult airways was associated with a reduced need to secure the airway surgically via cricothyrotomy or tracheostomy. The annual number of unplanned, emergency surgical airway procedures for inability to intubate and ventilate reported for the 4 yr before the program (January 1992 through December 1995) was compared with the annual number reported for the 11 yr after the program was initiated (January 1996 through December 2006). RESULTS: The number of emergency surgical airways decreased from 6.5 ± 0.5 per year for 4 yr before program initiation to 2.2 ± 0.89 per year for the 11-yr period after program initiation (P <0.0001). During the 4-yr period from January 1992 through December 1995, 26 surgical airways were reported, whereas only 24 surgical airways were performed in the subsequent 11-yr period (January 1996 through December 2006). CONCLUSIONS: A comprehensive difficult airway program was associated with a reduction in the number of emergency surgical airway procedures performed for the inability of an anesthesiologist to intubate and ventilate, a reduction that was sustained over an 11-yr period. This decrease occurred despite an increase in the number of patients reported to have a difficult airway and an overall increase in the total number of patients receiving anesthesia per year.

AB - BACKGROUND: Inability to intubate and ventilate patients with respiratory failure is associated with significant morbidity and mortality. A patient is considered to have a difficult airway if an anesthesiologist or other health care provider experienced in airway management is unable to ventilate the patient's lungs using bag-mask ventilation and/or is unable to intubate the trachea using direct laryngoscopy. METHODS: We performed a retrospective review of a departmental database to determine whether a comprehensive program to manage difficult airways was associated with a reduced need to secure the airway surgically via cricothyrotomy or tracheostomy. The annual number of unplanned, emergency surgical airway procedures for inability to intubate and ventilate reported for the 4 yr before the program (January 1992 through December 1995) was compared with the annual number reported for the 11 yr after the program was initiated (January 1996 through December 2006). RESULTS: The number of emergency surgical airways decreased from 6.5 ± 0.5 per year for 4 yr before program initiation to 2.2 ± 0.89 per year for the 11-yr period after program initiation (P <0.0001). During the 4-yr period from January 1992 through December 1995, 26 surgical airways were reported, whereas only 24 surgical airways were performed in the subsequent 11-yr period (January 1996 through December 2006). CONCLUSIONS: A comprehensive difficult airway program was associated with a reduction in the number of emergency surgical airway procedures performed for the inability of an anesthesiologist to intubate and ventilate, a reduction that was sustained over an 11-yr period. This decrease occurred despite an increase in the number of patients reported to have a difficult airway and an overall increase in the total number of patients receiving anesthesia per year.

UR - http://www.scopus.com/inward/record.url?scp=73949123843&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=73949123843&partnerID=8YFLogxK

U2 - 10.1213/ane.0b013e3181b2531a

DO - 10.1213/ane.0b013e3181b2531a

M3 - Article

C2 - 19713264

AN - SCOPUS:73949123843

VL - 109

SP - 1860

EP - 1869

JO - Anesthesia and Analgesia

JF - Anesthesia and Analgesia

SN - 0003-2999

IS - 6

ER -