Determination of the appropriate oropharyngeal airway size in adults: Assessment using ventilation and an endoscopic view

作者：Kim Hyun Joo; Kim Shin Hyung; Min Ji Young; Park Wyun Kon^*

来源：American Journal of Emergency Medicine, 2017, 35(10): 1430-1434.

DOI：10.1016/j.ajem.2017.04.029

• Airway assessment
• Airway management
• Difficult airway algorithm
• Ventilation modes

Introduction: Size 9 and 8 airways for men and women, respectively, have been proposed as most appropriate based on endoscopy. However, a limitation of this guideline is that ventilation was not assessed.
Methods: In this retrospective review of prospectively collected data, 149 patients requiring tracheal intubation for general anesthesia were included. The adequacy for manual and pressure-controlled mechanical ventilation and views at the distal end of each airway was assessed using a fiber-optic bronchoscope with various airway sizes (7, 8, 9, 10, and 11).
Results: Formen, size 9, 10, and 11 airways permitted clear manual and adequatemechanical ventilation; size 7 and 8 airways caused partially obstructed manual and inadequate mechanical ventilation. On endoscopy, size 7 and 8 airways caused complete obstruction by the tongue; size 10 and 11 airways either touched or passed beyond the tip of the epiglottis. For women, the size 7 airway caused partially obstructed manual and inadequate mechanical ventilation; size 9 and 10 airways provided clear manual and adequate mechanical ventilation. The size 8 airway permitted clear manual ventilation, though mechanical ventilation was inadequate in one patient. On endoscopy, the size 7 airway caused complete obstruction in <50% of women; size 9, 10, and 11 airways either touched or passed beyond the tip of the epiglottis.
Conclusions: With respect to adequate ventilation in conjunctionwith an acceptable endoscopic view, size 9 and size 8 oropharyngeal airways appear to be the most appropriate sizes for clinical use in men and women, respectively.

• 出版日期2017-10