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How to predict a difficult airway = Kako napovedati težavno oskrbo dihalne potiMekiš, DušanTežavna oskrba dihalne poti je po definiciji ameriškega anesteziološkega združenja klinična situacija, pri kateri ima izkušen anesteziolog težave s predihavanjem bolnika z masko in dihalnim balonom ... in/ali težave s prikazom grla z direktno laringoskopijo in vstavitvijo dihalne cevke. Strah pred neuspešno oskrbo dihalne poti spremlja vsakega zdravnika. Klinični pregled z oceno možnosti težavne oskrbe dihalne poti je obvezen pred vsako oskrbo dihalne poti tako pri otrocih kot pri odraslih. Z njim se izognemo nepričakovani težki oskrbi dihalne poti in posledičnim zapletom. Tveganje za težavno oskrbo dihalne poti ocenimo z anamnezo in pregledom medicinske dokumentacije ter usmerjenim kliničnim pregledom bolnika. Vsak test ali klinični znak, ki natančno oceni tveganje za težavno oskrbo dihalne poti, ima svojo senzitivnost in specifičnost za oceno tveganja težke oskrbe dihalne poti. Za vse teste ali klinične znake so značilne nizka associsenzitivnost, zmerna specifičnost in nizka pozitivna napovedna vrednost. Na podlagi multivariantne analize je bilo razvitih veliko točkovnih modelov, v katere so bili vključeni različni testi in klinični znaki z namenom izboljšanja napovedi težavne oskrbe dihalne poti, vendar z zelo različno točnostjo napovedi težke oskrbe dihalne poti. Evropsko združenje za anesteziologijo priporoča sistematsko uporabo ocenjevalnega modela pred vsako oskrbo dihalne poti, ki vključuje: Mallampatijev test, thiromentalno razdaljo, oceno odpiranja ust z medzobno razdaljo, oceno gibljivosti vratu, oceno podajnosti mandibularnega prostora in oceno gibljivosti spodnje čeljusti.Source: Acta medico-biotechnica : AMB. - ISSN 1855-5640 (Vol. 6, [no.] 1, 2013, str. 10-19)Type of material - article, component part ; adult, seriousPublish date - 2013Language - englishCOBISS.SI-ID - 4682303
Author
Mekiš, Dušan
Topics
dihalna pot, oskrba |
dihalna pot, ocena |
dihalna cevka |
dihalni balon |
maska |
predihavanje
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Mekiš, Dušan | 23184 |
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