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June 13, 2020
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Clinical Guidelines
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Recommendations for the evaluation and management of the anticipated and non-anticipated difficult airway of the Societat Catalana d'Anestesiologia, Reanimació i Terapèutica del Dolor, based on the adaptation of clinical practice guidelines and expert consensus

Publicated to:Revista Espanola De Anestesiologia Y Reanimacion. 67 (6): 325-342 - 2020-06-01 67(6), DOI: 10.1016/j.redar.2019.11.011

Authors: López AM, Belda I, Bermejo S, Parra L, Áñez C, Borràs R, Sabaté S, Carbonell N, Marco G, Pérez J, Massó E, Soto JM, Boza E, Gil JM, Serra M, Tejedor V, Tejedor A, Roza J, Plaza A, Tena B, Valero R, Secció de via aèria (SEVA) de la SCARTD, Listado de autores y miembros de la Secció de via aèria SEVA de la SCARTD

Affiliations

Althaia Xarxa Assistencial de Manresa - Author
Consorci Sanitari de Terrassa - Author
Consorci Sanitari Integral - Author
Fundació Puigvert - Author
Fundacion Hospital Asil de Granollers - Author
Hospital Clinic Barcelona - Author
Hospital Comarcal de l'Alt Penedes - Author
Hospital d'Igualada - Author
Hospital de la Santa Creu i Sant Pau - Author
Hospital de Santa Caterina - Author
Hospital d’ Igualada - Author
HOSPITAL MUNICIPAL DE BADALONA - Author
Hospital Sant Joan de Déu - Author
Hospital Santa Maria de Lleida - Author
Hospital Universitari Arnau de Vilanova de Lleida - Author
Hospital Universitari de Bellvitge - Author
Hospital Universitari de Girona Dr. Josep Trueta - Author
Hospital Universitari de Tarragona Joan XXIII - Author
Hospital Universitari de Vic - Author
Hospital Universitari Germans Trias i Pujol - Author
Hospital Universitari Parc Taulí - Author
Hospital Universitari Vall d'Hebron - Author
Parc de Salut Mar - Author
Parc Sanitari Sant Joan de Déu de Sant Boi - Author
Pius Hospital de Valls - Author
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Abstract

The Airway Division of the Catalan Society of Anaesthesiology, Intensive Care and Pain Management (SCARTD) presents its latest guidelines for the evaluation and management of the difficult airway. This update includes the technical advances and changes observed in clinical practice since publication of the first edition of the guidelines in 2008. The recommendations were defined by a consensus of experts from the 19 participating hospitals, and were adapted from 5 recently published international guidelines following an in-depth analysis and systematic comparison of their recommendations. The final document was sent to the members of SCARTD for evaluation, and was reviewed by 11 independent experts. The recommendations, therefore, are supported by the latest scientific evidence and endorsed by professionals in the field. This edition develops the definition of the difficult airway, including all airway management techniques, and places emphasis on evaluating and classifying the airway into 3 categories according to the anticipated degree of difficulty and additional safety considerations in order to plan the management strategy. Pre-management planning, in terms of preparing patients and resources and optimising communication and interaction between all professionals involved, plays a pivotal role in all the scenarios addressed. The guidelines reflect the increased presence of video laryngoscopes and second-generation devices in our setting, and promotes their routine use in intubation and their prompt use in cases of unanticipated difficult airway. They also address the increased use of ultrasound imaging as an aid to evaluation and decision-making. New scenarios have also been included, such as the risk of bronchoaspiration and difficult extubation Finally, the document outlines the training and continuing professional development programmes required to guarantee effective and safe implementation of the guidelines.Copyright © 2019. Publicado por Elsevier España, S.L.U.

Keywords

Anticipated difficult airwayAssociation 2016 guidelinesDifficult extubationDirect laryngoscopyEvaluacionEvaluationExtubación difícilFiberoptic intubationLaryngeal mask airwayMacintosh laryngoscopeNon-anticipated difficult airwayNontechnical skillsRecomendacionesRecommendationsSupraglottic airwayTracheal intubationVentilatory exchange thriveVía aérea difícil imprevistaVía aérea difícil previstaVideo-laryngoscopy

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Revista Espanola De Anestesiologia Y Reanimacion, Q3 Agency Scopus (SJR), its regional focus and specialization in Critical Care and Intensive Care Medicine, give it significant recognition in a specific niche of scientific knowledge at an international level.

Independientemente del impacto esperado determinado por el canal de difusión, es importante destacar el impacto real observado de la propia aportación.

Según las diferentes agencias de indexación, el número de citas acumuladas por esta publicación hasta la fecha 2025-07-26:

  • WoS: 1
  • Scopus: 3
  • Europe PMC: 1

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-26:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 62.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 101 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 7.25.
  • The number of mentions on the social network X (formerly Twitter): 12 (Altmetric).