Acta clinica Croatica
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The number of indications for lung collapse during different procedures is rising. Difficult upper airway is more often encountered with the need for single lung ventilation. ⋯ An alternative technique is exchanging the single-lumen for a double-lumen tube using an airway exchange catheter. When there is a tracheostomy in place, an independent bronchial blocker is recommended.
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The Fourth National Audit Project (NAP4) was set up by the Royal College of Anaesthetists and Difficult Airway Society to provide an insight into major complications of airway management in the United Kingdom. The NAP4 found that one serious airway complication such as death, brain damage, the need for surgical airway or unexpected intensive care admission, was reported for every 5500 general anaesthetics. Most of the events happened during daytime to a senior experienced clinicians. ⋯ Awake fibreoptic intubation was indicated and not performed in a significant number of reported incidents. Thirty percent of serious airway complications were associated with extubation or removal of laryngeal mask airway at the end of anaesthesia. The findings of the NAP4 have the potential to significantly influence airway management practice of all anaesthetists irrespective of where in the world they practice anaesthesia.