PMID- 38462998
OWN - NLM
STAT- MEDLINE
DCOM- 20240426
LR  - 20240429
IS  - 1460-9592 (Electronic)
IS  - 1155-5645 (Linking)
VI  - 34
IP  - 6
DP  - 2024 Jun
TI  - Emergency front-of-neck access in pediatric anesthesia: A narrative review.
PG  - 495-506
LID - 10.1111/pan.14875 [doi]
AB  - BACKGROUND AND OBJECTIVES: Children undergoing airway management during general 
      anesthesia may experience airway complications resulting in a rare but 
      life-threatening situation known as "Can't Intubate, Can't Oxygenate". This 
      situation requires immediate recognition, advanced airway management, and 
      ultimately emergency front-of-neck access. The absence of standardized 
      procedures, lack of readily available equipment, inadequate knowledge, and 
      training often lead to failed emergency front-of-neck access, resulting in 
      catastrophic outcomes. In this narrative review, we examined the latest evidence 
      on emergency front-of-neck access in children. METHODS: A comprehensive 
      literature was performed the use of emergency front-of-neck access (eFONA) in 
      infants and children. RESULTS: Eighty-six papers were deemed relevant by 
      abstract. Finally, eight studies regarding the eFONA technique and simulations in 
      animal models were included. For all articles, their primary and secondary 
      outcomes, their specific animal model, the experimental design, the target 
      participants, and the equipment were reported. CONCLUSION: Based on the available 
      evidence, we propose a general approach to the eFONA technique and a guide for 
      implementing local protocols and training. Additionally, we introduce the 
      application of innovative tools such as 3D models, ultrasound, and artificial 
      intelligence, which can improve the precision, safety, and training of this rare 
      but critical procedure.
CI  - (c) 2024 The Authors. Pediatric Anesthesia published by John Wiley & Sons Ltd.
FAU - Haag, Anna-Katharina
AU  - Haag AK
AD  - Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University 
      Hospital, University of Bern, Bern, Switzerland.
FAU - Tredese, Alberto
AU  - Tredese A
AD  - Unit for Research in Anesthesia, IRCCS Istituto Giannina Gaslini, Genova, Italy.
FAU - Bordini, Martina
AU  - Bordini M
AUID- ORCID: 0009-0007-8864-6744
AD  - Department of Anaesthesia and Pain Medicine, The Hospital for Sick Children, 
      Toronto, Ontario, Canada.
FAU - Fuchs, Alexander
AU  - Fuchs A
AD  - Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University 
      Hospital, University of Bern, Bern, Switzerland.
AD  - Unit for Research in Anesthesia, IRCCS Istituto Giannina Gaslini, Genova, Italy.
FAU - Greif, Robert
AU  - Greif R
AD  - University of Bern, Bern, Switzerland.
AD  - School of Medicine, Sigmund Freud University Vienna, Vienna, Austria.
FAU - Matava, Clyde
AU  - Matava C
AUID- ORCID: 0000-0002-9502-0981
AD  - Department of Anaesthesia and Pain Medicine, The Hospital for Sick Children, 
      Toronto, Ontario, Canada.
FAU - Riva, Thomas
AU  - Riva T
AUID- ORCID: 0000-0003-1297-3427
AD  - Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University 
      Hospital, University of Bern, Bern, Switzerland.
FAU - Scquizzato, Tommaso
AU  - Scquizzato T
AD  - Department of Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific 
      Institute, Milan, Italy.
FAU - Disma, Nicola
AU  - Disma N
AUID- ORCID: 0000-0002-2960-9333
AD  - Unit for Research in Anesthesia, IRCCS Istituto Giannina Gaslini, Genova, Italy.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20240311
PL  - France
TA  - Paediatr Anaesth
JT  - Paediatric anaesthesia
JID - 9206575
SB  - IM
MH  - Humans
MH  - Child
MH  - *Airway Management/methods
MH  - *Neck
MH  - Infant
MH  - Intubation, Intratracheal/methods
MH  - Anesthesia, General/methods
MH  - Child, Preschool
MH  - Pediatrics/methods
MH  - Pediatric Anesthesia
OTO - NOTNLM
OT  - difficult airway
OT  - emergency front-of-neck access (eFONA)
OT  - oxygenation
OT  - pediatric airway management
OT  - tracheostomy
EDAT- 2024/03/11 06:44
MHDA- 2024/04/26 06:56
CRDT- 2024/03/11 04:12
PHST- 2024/01/14 00:00 [revised]
PHST- 2023/10/11 00:00 [received]
PHST- 2024/02/22 00:00 [accepted]
PHST- 2024/04/26 06:56 [medline]
PHST- 2024/03/11 06:44 [pubmed]
PHST- 2024/03/11 04:12 [entrez]
AID - 10.1111/pan.14875 [doi]
PST - ppublish
SO  - Paediatr Anaesth. 2024 Jun;34(6):495-506. doi: 10.1111/pan.14875. Epub 2024 Mar 
      11.