Atemwegsmanagement in Schwerelosigkeit

Zusammenfassung

Das Ziel der vorliegenden Arbeit ist es, einen Überblick über den aktuellen Stand der Forschung zum Atemwegsmanagement in Schwerelosigkeit zu geben. Dafür wurde ein narratives Review von bisher publizierter Literatur über Atemwegsmanagement in (simulierter) Schwerelosigkeit erstellt. Mittels einer Suche in PubMed wurden 3 Originalarbeiten identifiziert, die das Atemwegsmanagement in Schwerelosigkeit untersucht haben. Alle 3 Studien wurden an menschlichen Modellen durchgeführt, 2 davon während Parabelflügen und eine Unterwasserstudie. Unter „Free-floating-Bedingungen“ war die Erfolgsrate zur Insertion eines supraglottischen Atemwegshilfsmittels (SGA) hervorragend (91–97 %). Die Erfolgsrate einer konventionellen Laryngoskopie war unter „Free-floating-Bedingungen” wesentlich schlechter und betrug 15–86 %. Die Sicherung des Atemwegs in Schwerelosigkeit scheint prinzipiell für eine Allgemeinanästhesie machbar. Hierbei ist es allerdings essenziell, dass der Anwender ausreichend gut trainiert ist und der Patient im Optimalfall fixiert ist. Die Verwendung eines SGA scheint in Schwerelosigkeit wesentlich einfacher zu sein.

Abstract

The aim of this review is to analyze the existing literature on airway management in the special situation of weightlessness during space missions. A narrative review of published literature on airway management in spaceflight and analogue environments using the database PubMed was conducted. Screening of literature identified 3 randomized comparative manikin studies, 2 of them in parabolic flights, 1 in a submerged setup. Under free-floating conditions, the insertion success rate of supraglottic airway devices (SGA) was excellent (91–97 %). The administration of artificial ventilation could be successfully achieved in weightlessness with SGA. The success rate of conventional laryngoscopy under free-floating conditions fluctuated between 15–86 %. It appears possible to safely manage the airway in weightlessness, provided that certain conditions are ensured, such as restraining the patient and operator for conventional orotracheal intubation. If airway protection is required with endotracheal intubation, both the operator and the patient should be restrained.

Key words

airway management - space - aerospace - microgravity - weightlessness - anesthesia - systematic review

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