Pediatric anesthesia & critical care

Airway management in neonates and infants: European Society of Anaesthesiology and Intensive Care and British Journal of Anaesthesia joint guidelines

Br J AnaesthPublished Clinical practice guideline

Methodological detailsGRADE methodology, PICO-guided structured literature search
  • GRADE methodology
  • PICO-guided structured literature search

Recommendations

As issued by the authors

  1. 1C

    Use medical history and physical examination to predict difficult airway management

  2. 1B

    Ensure adequate level of sedation or GA during airway management

  3. 1C

    Administer neuromuscular blocker before tracheal intubation when spontaneous breathing is not necessary

  4. 1B

    Use a videolaryngoscope with an age-adapted standard blade as first choice for tracheal intubation

  5. 1B

    Apply apnoeic oxygenation during tracheal intubation in neonates

  6. 1B

    Consider a SGA for rescue oxygenation and ventilation when tracheal intubation fails

  7. 1C

    Limit the number of tracheal intubation attempts

  8. 1C

    Use a stylet to reinforce and preshape tracheal tubes when hyperangulated videolaryngoscope blades are used and when the larynx is anatomically anterior

  9. 1C

    Verify intubation is successful with clinical assessment and end-tidal CO2 waveform

  10. 1B

    Apply high-flow nasal oxygenation, CPAP or nasal intermittent positive pressure ventilation for postextubation respiratory support, when appropriate

Original publication

Airway management in neonates and infants: European Society of Anaesthesiology and Intensive Care and British Journal of Anaesthesia joint guidelines. Br J Anaesth. Published 29 November 2023. doi:10.1016/j.bja.2023.08.040

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