Conceptos actuales en el manejo de la vía aérea difícil
Current Concepts in the Management of The Difficult Airway

Joseph C. Gabel Professor and Chairman,
Department of Anesthesiology
The University of Texas Medical School at Houston
Director of Advanced Airway Management
Memorial Hermann Hospital
Houston, Texas
Executive Director 2009-2010, Society for Airway Management
Anesthesiology News MAY 2010; VOLUME: 36:5


Management of the difficult airway remains one of the most relevant and challenging tasks for anesthesia care providers. Claims involving airway management continue to comprise an important aspect of the ASA Closed Claims Project database, which tracks all anesthesia-related insurance claims.


http://www.anestesia-dolor.org/Educacion-Continua/via-aerea/29.1.Manejo-actual-de-la-via-aerea.pdf

Revisión clínica: Edema post-extubación laríngea y fracaso de la extubación en pacientes adultos críticamente enfermos
Clinical review: Post-extubation laryngeal edema and extubation failure in critically ill adult patients

Bastiaan HJ Wittekamp, Walther NKA van Mook, Dave HT Tjan, Jan Harm Zwaveling and Dennis CJJ Bergmans.
Critical Care 2009, 13:233 (doi:10.1186/cc8142

Abstract
Laryngeal edema is a frequent complication of intubation. It often presents shortly after extubation as post-extubation stridor and results from damage to the mucosa of the larynx. Mucosal damage is caused by pressure and ischemia resulting in an inflammatory response. Laryngeal edema may compromise the airway necessitating reintubation. Several studies show that a positive cuff leak test combined with the presence of risk factors can identify patients with increased risk for laryngeal edema. Meta-analyses show that pre-emptive administration of a multiple-dose regimen of glucocorticosteroids can reduce the incidence of laryngeal edema
and subsequent reintubation. If post-extubation edema occurs this may necessitate medical intervention. Parenteral administration of corticosteroids, epinephrine nebulization and inhalation of a helium/oxygen mixture are potentially effective, although this has not been confirmed by randomized controlled trials. The use of non-invasive positive pressure ventilation is not indicated since this will delay reintubation. Reintubation should be considered early after onset of laryngeal edema to adequately secure an airway. Reintubation leads to increased cost, morbidity and mortality.

http://www.anestesia-dolor.org/Educacion-Continua/via-aerea/29.2.Revision_clinica_Edema_post-extubacion_laringea_y_fracaso_de_la_extubacion
_en_pacientes_adultos_
criticamente_enfermos.pdf