CHEST Guidelines-Rebuttal-From-Dr-Doerschug

Rebuttal-From-Dr-Doerschug_chest

Pdf Summary

The editorial presents a debate on whether anesthesiologists should be the primary specialists managing difficult airway cases in the Intensive Care Unit (ICU). Dr. J. Matthias Walz from the UMass Memorial Medical Center argues in favor, emphasizing the expertise of anesthesiologists in airway management. The consideration is given to the complexity of intubating critically ill patients, where complications can arise unpredictably, necessitating a high skill level. Dr. Walz highlights concerns about multiple intubation attempts, which can lead to severe complications like laryngeal edema, and suggests that the ultimate goal of intubation is to maintain cardiopulmonary stability.<br /><br />Conversely, Dr. Kevin C. Doerschug from the University of Iowa argues against the premise that anesthesiologists should automatically be the specialists of choice in ICU airway management. He points out that while anesthesiologists have expertise, pulmonologists with adequate skill and teamwork can effectively perform intubations and limit severe complications. He advocates that pulmonologists should increase their intubation proficiency and incorporate newer technologies like videolaryngoscopes and extraglottic airways into their practice to improve patient safety and outcomes. Dr. Doerschug stresses a systematic, team-oriented approach and collaboration between pulmonologists and anesthesiologists, rather than a competitive one.<br /><br />The editorial concludes that both specialties have unique competencies that, when combined, can enhance the management of difficult airways in the ICU and improve patient outcomes. The emphasis is on collaboration and systematic approaches to advance patient care, rather than competition between disciplines.

Keywords

anesthesiologists

pulmonologists

airway management

ICU

intubation

patient safety

collaboration

videolaryngoscopes

extraglottic airways

teamwork