Management of the child's airway under anaesthesia: The French guidelines

被引：31

作者：

Dadure, Christophe ^{[1
]}

Sabourdin, Nada ^{[2
]}

Veyckemans, Francis ^{[3
]}

Babre, Florence ^{[4
]}

Bourdaud, Nathalie ^{[5
]}

Dahmani, Souhayl ^{[6
,7
,8
]}

De Queiroz, Mathilde ^{[5
]}

Devys, Jean-Michel ^{[9
]}

Dubois, Marie-Claude ^{[9
]}

Kern, Delphine ^{[10
,11
]}

Laffargue, Anne ^{[3
]}

Laffon, Marc ^{[12
,13
]}

Lejus-Bourdeau, Corinne ^{[14
]}

Nouette-Gaulain, Karine ^{[15
,16
]}

Orliaguet, Gilles ^{[17
]}

Gayat, Etienne ^{[18
]}

Velly, Lionel ^{[19
]}

Salvi, Nadege ^{[20
]}

Sola, Chrystelle ^{[1
]}

机构：

[1] Univ Montpellier, Inst Genom Fonct, Dept Anesthesiol Reanimat Femme Mere Enfant, CHU Lapeyronie,CNRS,UMR 5203,INSERM,U 1191, F-34285 Montpellier 5, France

[2] Hop Armand Trousseau, AP HP, Dept Anesthesiol Reanimat, 26 Ave Dr Arnold Netter, F-75012 Paris, France

[3] Univ Hosp Lille, Jeanne Flandre Hosp, Dept Paediat Anaesthesia, F-59037 Lille, France

[4] Bergonie Inst, Dept Anaesthesia, F-33000 Bordeaux, France

[5] Hop Femme Mere Enfant, Dept Anestheiol Reanimat Pediat, F-69677 Bron, France

[6] Paris Diderot Univ, Robert Debre Univ Hosp, AP HP, Paris Sorbonne Cite,Dept Anaesthesia & Intens Car, F-75019 Paris, France

[7] Paris Diderot Univ Paris VII, PRES Paris Sorbonne Cite, Paris, France

[8] Robert Debre Univ Hosp, INSERM, U1141, DHU PROTECT, F-75019 Paris, France

[9] Fdn Ophtalmol Adolphe Rothschild, Serv Anesthesie Reanimat, 25 Rue Manin, F-75019 Paris, France

[10] Univ Hosp Toulouse, Dept Anaesthesia, Pl Dr Baylac,TSA 40031, F-31059 Toulouse 9, France

[11] Univ Hosp Toulouse, Dept Intens Care, Pl Dr Baylac,TSA 40031, F-31059 Toulouse 9, France

[12] Univ Hosp, Dept Anesthesia & Intens Care, Tours, France

[13] Med Univ Francois Rabelais, Tours, France

[14] CHU Nantes, Hop Mere Enfant, Hotel Dieu, Serv Anesthesie Reanimat Chirurg, F-44093 Nantes, France

[15] CHU Bordeaux, Hop Pellegrin, Serv Anesthesie Reanimat Pellegrin, Pl Amelie Raba Leon, F-33000 Bordeaux, France

[16] Univ Bordeaux, INSERM, U1211, Lab Malad Rares Genet & Metab MRGM, 176 Rue Leo Saignat, F-33000 Bordeaux, France

[17] Paris Descartes Univ Paris V, PRES Paris Sorbonne Cite,AP HP, EA08 Pharmacol & Evaluat Therapeut Chez Enfant &, Necker Enfants Malad Hosp,Dept Anaesthesia & Inte, F-75743 Paris, France

[18] Univ Paris Diderot, Lariboisiere Univ Hosp, Dept Anesthesiol & Intens Care, INSERM,UMR S 942,BioCANVAS, F-75010 Paris, France

[19] Aix Marseille Univ, Inst Neurosci Timone, CHU Timone Adultes, Serv Anesthesie Reanimat,UMR 7289, 264 Rue St Pierre,13005 MeCA, Marseille, France

[20] Necker Enfants Malad Hosp, AP HP, Dept Anaesthesia & Intens Care, F-75743 Paris, France

来源：

ANAESTHESIA CRITICAL CARE & PAIN MEDICINE | 2019年 / 38卷 / 06期

关键词：

Airway; Management; Children; Guidelines; LARYNGEAL MASK AIRWAY; RAPID-SEQUENCE-INDUCTION; UNCUFFED ENDOTRACHEAL-TUBES; STORZ VIDEO LARYNGOSCOPE; ANESTHETIZED PEDIATRIC-PATIENTS; RESPIRATORY REFLEX RESPONSES; TRACHEAL INTUBATION; DIFFICULT AIRWAY; ADVERSE EVENTS; RISK-FACTORS;

D O I：

10.1016/j.accpm.2019.02.004

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Objective: To provide French guidelines about "Airway management during paediatric anaesthesia". Design: A consensus committee of 17 experts from the French Society of Anaesthesia and Intensive Care Medicine (Societe Francaise d'Anesthesie-Reanimation, SFAR) and the Association of French speaking paediatric anaesthesiologists and intensivists (Association Des Anesthesistes Reanimateurs Pediatriques d'Expression Francophone, ADARPEF) was convened. The entire process was conducted independently of any industry funding. The authors followed the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE (R)) system to assess the quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasised. Few recommendations were not graded. Methods: The panel focused on 7 questions: 1) Supraglottic Airway devices 2) Cuffed endotracheal tubes 3) Videolaryngoscopes 4) Neuromuscular blocking agents 5) Rapid sequence induction 6) Airway device removal 7) Airway management in the child with recent or ongoing upper respiratory tract infection. Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles were generated. The analysis of the literature and the redaction of the recommendations were then conducted according to the GRADE (R) methodology. Results: The SFAR Guideline panel provides 17 statements on "airway management during paediatric anaesthesia''. After two rounds of discussion and various amendments, a strong agreement was reached for 100% of the recommendations. Of these recommendations, 6 have a high level of evidence (Grade 1 +/-), 6 have a low level of evidence (Grade 2 +/-) and 5 are experts' opinions. No recommendation could be provided for 3 questions. Conclusions: Substantial agreement exists among experts regarding many strong recommendations for paediatric airway management. (C) 2019 The Authors. Published by Elsevier Masson SAS on behalf of Societe francaise d'anesthesie et de reanimation (Sfar).

引用

页码：681 / 693

页数：13

共 146 条

[1] Videolaryngoscopy versus direct laryngoscopy for tracheal intubation in children (excluding neonates) [J].