A way forward in pulmonary aspiration incidence reduction: ultrasound, mathematics, and worldwide data collection
Braz. J. Anesth. (Impr.)
; 73(3): 301-304, May-June 2023.
Artigo
em Inglês
| LILACS
| ID: biblio-1439607
Biblioteca responsável:
BR891.2
ABSTRACT
Abstract Aspiration of gastric contents during induction of general anesthesia remains a significant cause of mortality and morbidity in anesthesia. Recent data show that pulmonary aspiration still accounts for many cases with implications on mortality despite technical and technological evolution. Practical, ethical, and methodological issues prevent high-quality research in the setting of aspiration and rapid sequence induction/intubation, and significant controversy is ongoing. Patients' position, drugs choice, dosing and timing, use of cricoid force, and a reliable risk assessment are widely debated with significant questions still unanswered. We focus our discussion on three approaches to promote a better understanding of rapid sequence induction/intubation and airway management decision-making. Firstly, we review how we can use qualitative and quantitative assessment of fasting status and gastric content with the point-of-care ultrasound as an integral part of preoperative evaluation and planning. Secondly, we propose using imaging-based mathematical models to study different patient positions and aspiration mechanisms, including identifying aspiration triggers. Thirdly, we promote the development of a global data collection system aiming to obtain precise epidemiological data. Therefore, we fill the gap between evidence-based medicine and experts' opinion through easily accessible and diffused computer-based databases. A better understanding of aspiration epidemiology obtained through focused global data gathering systems, the widespread use of ultrasound-based prandial status evaluation, and development of advanced mathematical models might potentially guide safer airway management decision making in the 21st century.
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Base de dados:
LILACS
Assunto principal:
Manuseio das Vias Aéreas
/
Anestesia Geral
Tipo de estudo:
Estudo de incidência
/
Estudo prognóstico
/
Pesquisa qualitativa
/
Fatores de risco
Aspecto:
Aspectos éticos
Limite:
Humanos
Idioma:
Inglês
Revista:
Braz. J. Anesth. (Impr.)
Ano de publicação:
2023
Tipo de documento:
Artigo
País de afiliação:
Itália
/
Eslovênia
/
Suíça
Instituição/País de afiliação:
AOU Policlinico San Marco/IT
/
University Medical Centre Maribor/SI
/
University of Bern/CH
/
University of Ljubljana/SI