Airway management in hospital. Methodological recommendations of the All-Russian public organization “Federation of Anesthesiologists and Reanimatologists” (third edition)

Abstract

The review presents the guidelines of the Federation of Anesthesiologists and Resuscitators, revised in 2021. The recommendations are based on a review of publications and current international guidelines of the Society for Difficult Airways (2018, 2020), the American Society of Anesthesiologists (2013, draft-version 2022), the European Society anesthesiologists (2018). The guidelines provide up-to-date definitions of various “difficult airway” situations; modern data on the use of ultrasound technologies in assessing the upper airways and predicting the risk of aspiration based on preoperative ultrasound scanning of the stomach; current evidence on the effectiveness of modern devices for ventilation and tracheal intubation. Algorithms of actions in various situations with anticipated and unanticipated “difficult airways” in patients with different risks of aspiration are proposed. An algorithm for preparing, predicting possible complications and performing tracheal extubation is also proposed. The recommendations presented in the review are aimed at achieving the goal - increasing patient safety during situations of “difficult airways” through the use of the safest and most effective approaches and methods, as well as reducing the risk of complications associated with these situations (death, severe neurological damage, traumatic injuries of the upper airways and trachea, etc.).