The anatomical mechanism of “cannot ventilate, cannot intubate” Yoshitaka AOKI 1 , Mikio NAKAJIMA 2 1Department of Intensive Care Unit Hamamatsu University School of Medicine 2Emergency and Critical Care Center Tokyo Metropolitan Hiroo Hospital pp.635-644
Published Date 2019/10/1
DOI https://doi.org/10.11477/mf.3102200679
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Cannot ventilate, cannot intubate (CVCI) is a fatal adverse event related to airway management. However, there is no strict definition of CVCI. Similar to difficulties with mask ventilation, the main anatomical mechanism of CVCI is presumed to be upper airway narrowing, caused by multiple factors including sinking of the tongue base and soft palate. CVCI also occurs during airway procedures such as tracheal intubation even in patients with normal anatomy. Compared with patients undergoing general anesthesia for elective surgeries, patients in the ICU may have lower oxygen reserve and more airway difficulties, which may result in serious complications such as death and brain damage. Currently, the frequency of CVCI is decreasing because of improved technical skills including those with video laryngoscopes, and relevant clinical practice guidelines. Non-technical skills are also important for management when CVCI occurs.

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