Extubation of the Challenging or Difficult Airway

Parotto, Matteo; Cooper, Richard M.; Behringer, Elizabeth C.

PURPOSE OF REVIEW: This review explores relevant definitions, epidemiology, management, and potential future research directions in the extubation of the challenging/difficult airway. It provides guidance on identifying patients at risk and how to approach these clinical scenarios. RECENT FINDINGS: Based on recent literature, including large-scale audits and closed claims analysis, it is increasingly recognized that extubation of the difficult airway is a situation at risk of severe adverse events. Some strategies to manage the extubation of the challenging/difficult airway have been described. SUMMARY: Extubating the challenging/difficult airway is a high-risk situation. However, it is fundamental to keep in mind that intended extubation is always an elective procedure. As such, it is imperative to adhere to principles of careful patient and context assessment, planning, and execution only when optimal conditions have been secured.