Republication: All India difficult airway association 2016 guidelines for tracheal intubation in the intensive care unit

Sheila Nainan Myatra, Syed Moied Ahmed, Pankaj Kundra, Rakesh Garg, Venkateswaran Ramkumar, Apeksh Patwa, Amit Shah, Ubaradka S. Raveendra, Sumalatha Radhakrishna Shetty, Jeson Rajan Doctor, Dilip K. Pawar, Singaravelu Ramesh, Sabyasachi Das, Jigeeshu Vasishtha Divatia

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Tracheal intubation (TI) is a routine procedure in the Intensive Care Unit (ICU) and is often lifesaving. In contrast to the controlled conditions in the operating room, critically ill patients with respiratory failure and shock are physiologically unstable. These factors, along with under evaluation of the airway and suboptimal response to preoxygenation, are responsible for a high incidence of life-threatening complications such as severe hypoxemia and cardiovascular collapse during TI in the ICU. The All India Difficult Airway Association (AIDAA) proposes a stepwise plan for safe management of the airway in critically ill patients. These guidelines have been developed based on available evidence; Wherever, robust evidence was lacking, recommendations were arrived at by consensus opinion of airway experts, incorporating the responses to a questionnaire sent to members of the (AIDAA) and Indian Society of Anaesthesiologists. Noninvasive positive pressure ventilation for preoxygenation provides adequate oxygen stores during TI for patients with respiratory pathology. Nasal insufflation of oxygen at 15 L/min can increase the duration of apnea before hypoxemia sets in. High flow nasal cannula oxygenation at 60-70 L/min may also increase safety during intubation of critically ill patients. Stable hemodynamics and gas exchange must be maintained during rapid sequence induction. It is necessary to implement an intubation protocol during routine airway management in the ICU. Adherence to a plan for difficult airway management incorporating the use of intubation aids and airway rescue devices and strategies is useful.

Original languageEnglish
Pages (from-to)146-153
Number of pages8
JournalIndian Journal of Critical Care Medicine
Volume21
Issue number3
DOIs
Publication statusPublished - 01-03-2017
Externally publishedYes

Fingerprint

Intubation
Intensive Care Units
India
Guidelines
Airway Management
Critical Illness
Oxygen
Insufflation
Positive-Pressure Respiration
Expert Testimony
Apnea
Operating Rooms
Nose
Respiratory Insufficiency
Shock
Gases
Hemodynamics
Pathology
Safety
Equipment and Supplies

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

Cite this

Myatra, Sheila Nainan ; Ahmed, Syed Moied ; Kundra, Pankaj ; Garg, Rakesh ; Ramkumar, Venkateswaran ; Patwa, Apeksh ; Shah, Amit ; Raveendra, Ubaradka S. ; Shetty, Sumalatha Radhakrishna ; Doctor, Jeson Rajan ; Pawar, Dilip K. ; Ramesh, Singaravelu ; Das, Sabyasachi ; Divatia, Jigeeshu Vasishtha. / Republication : All India difficult airway association 2016 guidelines for tracheal intubation in the intensive care unit. In: Indian Journal of Critical Care Medicine. 2017 ; Vol. 21, No. 3. pp. 146-153.
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abstract = "Tracheal intubation (TI) is a routine procedure in the Intensive Care Unit (ICU) and is often lifesaving. In contrast to the controlled conditions in the operating room, critically ill patients with respiratory failure and shock are physiologically unstable. These factors, along with under evaluation of the airway and suboptimal response to preoxygenation, are responsible for a high incidence of life-threatening complications such as severe hypoxemia and cardiovascular collapse during TI in the ICU. The All India Difficult Airway Association (AIDAA) proposes a stepwise plan for safe management of the airway in critically ill patients. These guidelines have been developed based on available evidence; Wherever, robust evidence was lacking, recommendations were arrived at by consensus opinion of airway experts, incorporating the responses to a questionnaire sent to members of the (AIDAA) and Indian Society of Anaesthesiologists. Noninvasive positive pressure ventilation for preoxygenation provides adequate oxygen stores during TI for patients with respiratory pathology. Nasal insufflation of oxygen at 15 L/min can increase the duration of apnea before hypoxemia sets in. High flow nasal cannula oxygenation at 60-70 L/min may also increase safety during intubation of critically ill patients. Stable hemodynamics and gas exchange must be maintained during rapid sequence induction. It is necessary to implement an intubation protocol during routine airway management in the ICU. Adherence to a plan for difficult airway management incorporating the use of intubation aids and airway rescue devices and strategies is useful.",
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Myatra, SN, Ahmed, SM, Kundra, P, Garg, R, Ramkumar, V, Patwa, A, Shah, A, Raveendra, US, Shetty, SR, Doctor, JR, Pawar, DK, Ramesh, S, Das, S & Divatia, JV 2017, 'Republication: All India difficult airway association 2016 guidelines for tracheal intubation in the intensive care unit', Indian Journal of Critical Care Medicine, vol. 21, no. 3, pp. 146-153. https://doi.org/10.4103/ijccm.IJCCM-57-17

Republication : All India difficult airway association 2016 guidelines for tracheal intubation in the intensive care unit. / Myatra, Sheila Nainan; Ahmed, Syed Moied; Kundra, Pankaj; Garg, Rakesh; Ramkumar, Venkateswaran; Patwa, Apeksh; Shah, Amit; Raveendra, Ubaradka S.; Shetty, Sumalatha Radhakrishna; Doctor, Jeson Rajan; Pawar, Dilip K.; Ramesh, Singaravelu; Das, Sabyasachi; Divatia, Jigeeshu Vasishtha.

In: Indian Journal of Critical Care Medicine, Vol. 21, No. 3, 01.03.2017, p. 146-153.

Research output: Contribution to journalArticle

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AU - Garg, Rakesh

AU - Ramkumar, Venkateswaran

AU - Patwa, Apeksh

AU - Shah, Amit

AU - Raveendra, Ubaradka S.

AU - Shetty, Sumalatha Radhakrishna

AU - Doctor, Jeson Rajan

AU - Pawar, Dilip K.

AU - Ramesh, Singaravelu

AU - Das, Sabyasachi

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