الفهرس | Only 14 pages are availabe for public view |
Abstract A irway complications could present during airway instrumentation (e.g. intubation), early within 48 hours or even delayed to present days after airway manipulation (e.g. tracheal stenosis following prolonged intubation). Airway complications could be classified according to the anatomical site of injury to (1) Supraglottic complications e.g.dental damage and tube obstruction. (2) Glottic complications e.g. sore throat, glottic edema and hoarseness. (3) Infraglottic complications e.g.esophageal intubation, endobronchial intubation and mechanical damage to esophagus or trachea. There are several complications of nasotracheal intubation e.g epistaxis & esophageal or tracheal trauma. Also there are iatrogenic complications of larynx as voice dysfunction after thyroidectomy. Physiological responses to airway instrumentation could be considerd also complications of the airway as laryngospasm, bronchospasm, hypertension, tachycardia, increased intracranial and intraocular pressures. Factors contributing to airway complications are abnormal airway anatomy, characteristics of the tube itself, difficult laryngoscopy, critically ill patients, multiple intubations & lack of skill of the operator. Successful airway management requires competent decision- making and good procedural skills. Each of the airway complication has a different way of management. For example, Hoarseness can be treated simply by resting the voice or modifying how it is used. Esophageal perforation is treated either surgically or medically, surgery has been the most common treatment, but in selected cases medical management may give better results. Medical management consists of intravenous fluids, broad-spectrum antibiotics & nasogastric suction. Glottic, laryngeal and tracheal edema can be treated with conservative therapy. Negative Pressure-Pulmonary Edema can be treated with oxygen and diuretics which is sufficient. Airway management must begin with a proper airway assessment. |