The problem of “difficult airways” — multicenter studies of Federation of anaesthesiologists and reanimatologists to analyze current clinical practice and review the training system in the Russian Federation. Review

A.A. Andreenko1, E.L. Dolbneva2, V.I. Stamov3

1 FGBVOU VO “Military Medical Academy named after S.M. Kirov” Ministry of Defence of Russia, St. Petersburg, Russia

2 FGBNU “RNCH named by acad. B.V. Petrovsky”, Moscow, Russia

3 UKB № 2 FGAOU VO “Moscow State Medical University named after I.M. Sechenov” Ministry of Health of Russia, Moscow, Russia

For correspondence: Aleksander A. Andreenko — Cand. Med. Sciences, Assistant Professor, Deputy Head of the Department of Anesthesiology and Resuscitation FGBVOU VO “Military Medical Academy named after S.M. Kirov” Ministry of Defence of Russia, St. Petersburg; e-mail:

For citation: Andreenko AA, Dolbneva EL, Stamov VI. The problem of “difficult airways” — multicenter studies of Federation of anaesthesiologists and reanimatologists  to analyze current clinical practice and review the training system in the Russian Federation. Review. Annals of Critical Care. 2019;3:34–41.

DOI: 10.21320/1818-474X-2019-3-34-41


“Difficult airways” situations continue to be one of the main causes of anesthetic mortality and morbidity. Current requirements of patient safety during anesthesia determine the need for the necessary equipment and compliance with existing clinical guidelines. The situation with the equipment of hospitals in the Russian Federation with different airway devices and medical equipment, as well as the approaches used by anesthesiologists are regularly reviewed by the FAR Committee of Difficult Airways by distributing a questionnaire. During the last 10 years there has been a positive trend in the level of hospital equipment with supraglottic airways, there has been an increase in the awareness of specialists about the existing clinical guidelines. An updated version of the survey was developed to examine the current situation in the Russian Federation, to analyze the effectiveness of the approaches used to solve the problem of “difficult airways” and to evaluate the role of the existing recommendations of the FAR.

The role of the human factor is decisive in the development of a significant part of critical situations during anesthesia. A modern training program for clinical residents in anesthesiology should include training in upper airways assessment, performing basic maneuvers of airways management, working out techniques for using various devices, as well as using existing algorithms of actions during “difficult airways” situations. The ability to apply theoretical knowledge and act requires training in a high-fidelity simulation and subsequent analysis of residentʹs performance. The newly developed survey is devoted to the analysis of the situation with airways management training in the clinical residency. Based on the results of the survey, it is planned to develop a draft national airways management training program for anesthesia residents.

Keywords: airways management, difficult airways, human factor, critical situations, airways management training, national survey of airways management.

Received: 22.07.2019

Accepted: 03.09.2019


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