Developing an Extubation strategy for the difficult pediatric airway-Who, when, why, where, and how?

Andrew D Weatherall; Renee D Burton; Michael G Cooper; Susan R Humphreys

doi:10.1111/pan.14411

Developing an Extubation strategy for the difficult pediatric airway-Who, when, why, where, and how?

Paediatr Anaesth. 2022 May;32(5):592-599. doi: 10.1111/pan.14411. Epub 2022 Feb 25.

Authors

Andrew D Weatherall^{1

2}, Renee D Burton¹, Michael G Cooper¹, Susan R Humphreys^{3

4}

Affiliations

¹ Department of Anaesthesia, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
² Division of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia.
³ Paediatric Critical Care Research Group, Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia.
⁴ Department of Anaesthesia and Pain Management, Queensland Children's Hospital, South Brisbane, Queensland, Australia.

Abstract

Comprehensive airway management of the pediatric patient with a difficult airway requires a plan for the transition back to a patent and protected airway. Multiple techniques are available to manage the periextubation period. Equally important is performing a comprehensive risk assessment and developing a strategy that optimizes the likelihood of safe extubation. This includes team-focused communication of the desired goals, critical steps in the process, and potential responses in the case of failed extubation. This review summarizes extubation of pediatric patients with difficult airways along with one suggested framework to manage this challenging period.

Keywords: airway extubation; airway management; pediatrics.

Publication types

Review

MeSH terms

Airway Extubation* / methods
Airway Management* / methods
Child
Communication
Humans
Intubation, Intratracheal / methods
Respiratory System
Risk Assessment