《疑似或确诊颈椎损伤患者的气道管理指南》解读

Interpretation of guidelines for airway management in patients with suspected or confirmed cervical spine injury

中文关键词: 颈椎损伤  气道管理  插管  脊髓损伤  指南

英文关键词: Cervical spine injury  Airway management  Intubation  Spinal cord injury  Guidelines

中文摘要:

      疑似或确诊颈椎损伤患者的气道管理可能会加重现有的神经功能损伤或由于预防神经损伤而造成危险，临床上尚无安全有效气道管理的循证指南。2024年5月困难气道协会（DAS）联合多家学会共同制定了《疑似或确诊颈椎损伤患者的气道管理指南》。该指南强调预充氧和面罩通气、声门上气道装置使用、气管插管、插管辅助工具等关键原则和技术，讨论了人为因素、院前监护和军事环境原则，旨在提高疑似或确诊颈椎损伤的成人患者气道管理的安全性和有效性，从而最大限度地减少气道并发症和颈椎损伤的风险，改善患者预后。

英文摘要:

      Airway management in patients with suspected or confirmed cervical spine injury may exacerbate an existing neurological deficit or be hazardous due to precautions to avoid neurological injury. There are no evidence-based guidelines for practicing clinicians to support safe and effective airway management in this settings. The Difficult Airway Society (DAS) in collaboration with several professional associations has developed guidelines for airway management in patients with suspected or confirmed cervical spine injuries in May 2024. The guideline emphasize key principles and techniques such as pre-oxygenation, mask ventilation, supraglottic airway devices, intubation, and laryngoscopic assistance, while also addressing human factors, pre-hospital care, and military settings. The aim is to enhance the safety and efficacy of airway management in adult patients with suspected or confirmed cervical spine injuries, thereby minimizing the risk of airway complications and further spinal cord injury, ultimately improving patient outcomes.