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Published in: Current Anesthesiology Reports 3/2022

14-03-2022 | Pathology | Airway Management (LC Berkow, Section Editor)

Airway Management in Cervical Spine Pathologies

Authors: Mariel Manlapaz, Jean Beresian, Rafi Avitsian

Published in: Current Anesthesiology Reports | Issue 3/2022

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Abstract

Purpose of Review

Traumatic and non-traumatic pathologic processes can make airway management difficult. An understanding of pathologic mechanisms is important in identifying patients at risk. We aim to present a classification of cervical spine pathologies that can affect airway management.

Recent Findings

Stability of the cervical spine relates to its ability to limit the pattern of displacement under physiologic loads. Traumatic injuries are common but not the only causes of instability. Not all cervical spine pathologies are unstable. Secondary injuries can occur following movement, hypotension, or hypoxemia. Recently, there have been changes in guidelines of cervical spine movement and clearing of the cervical spine. History, physical exam, radiologic study, and communication with the surgeon are keys to planning a successful airway management strategy. Unnecessary immobilization can have deleterious effects. Displacement can happen during mask ventilation and placement of supraglottic airways. Flexible bronchoscopy, videolaryngoscopy, and manual inline stabilization can decrease cervical spine movement. Vigilance during and after extubation is crucial to diagnose airway impairment.

Summary

A careful attention to pathophysiology of cervical spine injuries and deformities, review of imaging, and availability of trained and expert individuals are important in the management of these patients.
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Metadata
Title
Airway Management in Cervical Spine Pathologies
Authors
Mariel Manlapaz
Jean Beresian
Rafi Avitsian
Publication date
14-03-2022
Publisher
Springer US
Published in
Current Anesthesiology Reports / Issue 3/2022
Electronic ISSN: 2167-6275
DOI
https://doi.org/10.1007/s40140-022-00523-3

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