Trends in Anaesthesia and Critical Care最新文献

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Face mask ventilation – to paralyze or not to paralyze, is that the question? 口罩通风——麻痹还是不麻痹，是这个问题吗？

IF 0.7 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care

Pub Date : 2026-01-22 DOI: 10.1016/j.tacc.2026.101637

Pavel Michalek , Manuel Á. Gómez-Ríos , Ana Isabel Pereira , Tomasz Gaszynski

引用次数: 0

Seconds from collapse: Awake intubation in a fast-deforming postoperative airway 离崩溃还有几秒：在快速变形的术后气道中进行清醒插管

IF 0.7 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care

Pub Date : 2026-01-20 DOI: 10.1016/j.tacc.2026.101636

Catarina Cruz Chaves, José Paulo Santos Ferreira, Manuel Silva

Postoperative cervical hematoma is a life-threatening cause of airway obstruction, particularly after extensive head and neck surgery. The 2025 Difficult Airway Society (DAS) guidelines highlight the need for early recognition of airway compromise, preservation of spontaneous ventilation, and prioritization of awake techniques when anatomical distortion is anticipated. We report a 55-year-old man with parotid carcinoma who underwent a 10-h elective parotidectomy with a transcoclear petrosectomy approach. He was admitted ventilated to the post-anaesthesia care unit and extubated uneventfully 20 hours later. On postoperative day 4, he developed rapidly progressive cervical swelling requiring urgent surgical re-exploration. Given the severe anatomical distortion and impending airway compromise, a multidisciplinary airway strategy was formulated, and awake flexible bronchoscopic intubation was performed under spontaneous ventilation, with ENT surgeons prepared for immediate surgical rescue. Nasal fibreoptic intubation was initially hindered by marked supraglottic oedema and distorted upper airway anatomy, but successful nasotracheal intubation was achieved on the second attempt. CT imaging confirmed a large multiloculated cervical hematoma with substantial mass effect and airway displacement. This case reinforces key DAS 2025 and ASA 2022 principles in emergency airway management and underscores the critical role of awake flexible bronchoscopic intubation in the setting of rapidly evolving postoperative airway distortion.

术后颈部血肿是危及生命的气道阻塞原因，特别是在广泛的头颈部手术后。2025年气道困难协会（DAS）指南强调了早期识别气道损伤、保留自发通气以及在预期解剖扭曲时优先采用清醒技术的必要性。我们报告一位55岁的男性腮腺癌患者，他接受了10小时的选择性腮腺切除术和经透明的岩石切除术。他在麻醉后护理病房接受了通气治疗，20小时后顺利拔管。术后第4天，患者出现颈椎迅速进行性肿胀，需要紧急再次手术探查。鉴于严重的解剖扭曲和即将发生的气道损害，制定了多学科气道策略，在自主通气下进行清醒柔性支气管镜插管，耳鼻喉外科医生准备立即进行手术抢救。鼻纤维插管最初因声门上明显水肿和上呼吸道解剖扭曲而受阻，但在第二次尝试时成功进行鼻气管插管。CT影像证实了一个大的多室宫颈血肿，有大量的肿块效应和气道移位。本病例强化了DAS 2025和ASA 2022在紧急气道管理中的关键原则，并强调了清醒柔性支气管镜插管在快速发展的术后气道扭曲情况下的关键作用。

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引用次数: 0

Density spectral array emergence pattern during TIVA: Neurophysiological and clinical implications 密度谱阵列出现模式在TIVA：神经生理和临床意义

IF 0.7 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care

Pub Date : 2026-01-19 DOI: 10.1016/j.tacc.2026.101633

Carolina Frederico Avendaño , Sarah Saxena , Joana Berger-Estilita

Emergence from anesthesia involves structured cortical transitions that are visible on the density spectral array (DSA). The “open crocodile upper jaw” pattern, defined by the separation of slow delta and re-emerging beta-gamma activity, has gained attention as a physiological marker and a teaching tool. Here, we contextualize this visual mnemonic phenomenon within established neurophysiology and emphasize its importance in understanding recovery from general anesthesia. This article provides new value by formally contextualizing an informal EEG teaching cue within established neurophysiology and translating it into a practical, clinically interpretable framework.

在密度谱阵列（DSA）上可以看到麻醉后出现的结构皮层转变。“张开的鳄鱼上颚”模式，由缓慢的三角洲和重新出现的β - γ活动的分离所定义，作为一种生理标志和教学工具而受到关注。在这里，我们将这种视觉助记现象置于已建立的神经生理学背景下，并强调其在理解全身麻醉恢复中的重要性。本文提供了新的价值，通过正式背景下的非正式脑电图教学线索在既定的神经生理学，并将其转化为一个实用的，临床可解释的框架。

引用次数: 0

A sudden “can't ventilate–can't intubate” crisis: The hidden pathology behind a silent airway 突然的“不能通气-不能插管”危机：无声气道背后隐藏的病理

IF 0.7 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care

Pub Date : 2026-01-19 DOI: 10.1016/j.tacc.2026.101635

Catarina Cruz Chaves, Francisca Santos

Unanticipated difficult airway remains a major cause of anaesthetic morbidity, often arising abruptly during seemingly routine inductions. Contemporary difficult airway frameworks emphasize early declaration of difficulty, minimization of repeated attempts, prioritisation of oxygenation, and restoration of spontaneous ventilation whenever feasible. We report the case of a 71-year-old man scheduled for urgent transurethral resection of a bladder tumour who developed a sudden “can't ventilate–can't intubate” (CVCI) event immediately after an apparently straightforward induction, despite the absence of major predictors of a difficult airway. Failure of both supraglottic airway ventilation and face-mask ventilation rapidly transformed a routine induction into a critical airway emergency, necessitating awakening of the patient to restore spontaneous ventilation. Subsequent ear, nose and throat assessment revealed a previously undiagnosed infiltrative supraglottic mass. Definitive airway management was later achieved under preserved spontaneous ventilation using videolaryngoscopy. This case illustrates a scenario uncomfortably familiar to experienced anaesthetists, in which a familiar clinical pathway suddenly diverges into a life-threatening airway crisis. It underscores the importance of early recognition of failed ventilation, consideration of occult laryngeal pathology in CVCI situations, and adherence to contemporary difficult airway principles.

意外的气道困难仍然是麻醉发病的主要原因，通常在看似常规的诱导过程中突然出现。当代气道困难框架强调早期发现困难，尽量减少重复尝试，优先供氧，并在可行的情况下恢复自然通气。我们报告了一例71岁的男性患者，他计划紧急经尿道膀胱肿瘤切除术，在明显的直接诱导后立即出现突然的“不能通气-不能插管”（CVCI）事件，尽管没有主要的气道困难预测因素。声门上气道通气和面罩通气均失败，迅速将常规诱导转变为严重的气道急诊，需要唤醒患者以恢复自发通气。随后的耳、鼻、喉检查显示先前未确诊的浸润性声门上肿块。最终气道管理是在保留的自发通气下通过视频喉镜实现的。这个病例说明了一个经验丰富的麻醉师所熟悉的令人不安的场景，在这个场景中，一个熟悉的临床途径突然分化成危及生命的气道危机。它强调了早期识别通气失败的重要性，在CVCI情况下考虑隐性喉病理，并坚持当代困难气道原则。

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引用次数: 0

Navigating the swollen airway: Awake videolaryngoscopy as a rescue strategy after failed awake fibreoptic intubation in severe supraglottic edema – A case report 导航肿胀的气道：清醒视频喉镜作为严重声门上水肿清醒纤维插管失败后的抢救策略- 1例报告

IF 0.7 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care

Pub Date : 2026-01-17 DOI: 10.1016/j.tacc.2026.101634

Maria Carvalho , Gonçalo Pinto , Marta Afonso , Ana Belinha , Helena Barbosa , Ana Isabel Pereira

Acute supraglottic edema can rapidly progress to airway obstruction and awake fibreoptic intubation is often considered first-line approach. We report a case of life-threatening supraglottic swelling where awake fibreoptic intubation failed due to marked edema and airway reactivity. Awake videolaryngoscopy enabled successful tracheal intubation, securing the airway while preserving spontaneous ventilation. This case highlights the importance of flexibility in airway strategy selection, the value of videolaryngoscopy as a rescue technique and the essential role of multidisciplinary coordination in upper airway emergencies.

急性声门上水肿可迅速发展为气道阻塞，清醒纤维插管通常被认为是一线方法。我们报告一个危及生命的声门上肿胀的情况下，清醒纤维插管失败，由于明显的水肿和气道反应。清醒视频喉镜检查使气管插管成功，在保持自发通气的同时保护气道。本病例强调了气道策略选择灵活性的重要性，视频喉镜作为一种抢救技术的价值，以及多学科协调在上呼吸道紧急情况中的重要作用。

引用次数: 0

Awake fibreoptic intubation in a rapidly deteriorating airway following blunt trauma to an advanced tongue carcinoma 晚期舌癌钝性创伤后迅速恶化气道的清醒纤维插管

IF 0.7 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care

Pub Date : 2026-01-17 DOI: 10.1016/j.tacc.2026.101632

J. Orankiewicz , B. Sadownik , P. Andruszkiewicz

引用次数: 0

Toward a physiological approach to airway management in the critically ill: The utility of the ABCDE framework 迈向危重病人气道管理的生理途径：ABCDE框架的应用

IF 0.7 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care

Pub Date : 2026-01-14 DOI: 10.1016/j.tacc.2026.101631

R. Albillos-Almaraz , S. Balboa-Palomino , J. Fanjul-Cuesta

引用次数: 0

Letter To The Editor Regarding “Comparative efficacy of ciprofol and propofol for sedation in patients undergoing colonoscopy: A systematic review, meta-analysis and trial sequential analysis of randomized controlled trials” 关于“环丙酚和异丙酚用于结肠镜检查患者镇静的比较疗效：随机对照试验的系统回顾、荟萃分析和试验序贯分析”的致编辑信

IF 0.7 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care

Pub Date : 2026-01-07 DOI: 10.1016/j.tacc.2026.101630

Saul Dominici , Italo C. Martins , Breno Dias L. Ribeiro , Victor Arthur Ohannesian , Brunno Braga Sauaia , Caio Márcio Barros de Oliveira , Plínio da Cunha Leal

引用次数: 0

Novel dual-port technique using fogarty balloon catheter for life-threatening rice silo aspiration: A case report 使用福格蒂球囊导管的新型双端口技术用于危及生命的水稻筒仓吸入：1例报告

IF 0.7 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care

Pub Date : 2025-12-31 DOI: 10.1016/j.tacc.2025.101621

Kanwaljit Singh , Eshaan Kaushik , Ankush Nayyar

Airway obstruction from foreign bodies in the aerodigestive tract is a common emergency, but massive aspiration of fine particulate matter can present unique challenges. Conventional tools such as rigid bronchoscopy or standard forceps may be insufficient in such cases. We report a rare case of a male patient who suffered massive rice particle aspiration, presenting with acute respiratory failure. The patient was successfully managed using a novel dual-port technique involving a Fogarty balloon catheter and a pediatric endotracheal tube during flexible bronchoscopy. This approach allowed effective foreign body extraction while minimizing airway trauma. This case highlights the potential of innovative, minimally invasive techniques in complex airway management and expands the applications of flexible bronchoscopy when standard interventions are inadequate.

气管消化道异物引起的气道阻塞是一种常见的紧急情况，但大量吸入细颗粒物可能会带来独特的挑战。在这种情况下，传统的工具如刚性支气管镜检查或标准钳可能是不够的。我们报告一个罕见的情况下，男性患者遭受大量大米颗粒吸入，呈现急性呼吸衰竭。在柔性支气管镜检查期间，患者成功地使用了一种新的双端口技术，包括福格蒂球囊导管和儿童气管内管。这种方法可以有效地取出异物，同时最大限度地减少气道创伤。本病例强调了创新的微创技术在复杂气道管理中的潜力，并在标准干预措施不足的情况下扩展了柔性支气管镜的应用。

引用次数: 0

A commentary on evaluation of renal outcomes in the critically ill 危重病人肾脏预后评价综述

IF 0.7 Q3 ANESTHESIOLOGY

Trends in Anaesthesia and Critical Care

Pub Date : 2025-12-09 DOI: 10.1016/j.tacc.2025.101620

Rohan Magoon , Varun Suresh

引用次数: 0

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