For the past half century, intubation of the trachea with a cuffed tube has been the method of choice to provide a patent airway in patients with respiratory failure. Although the time-honored principles of airway management remain unchanged, new advances in airway care continue to appear. Critical care physicians should stay abreast of these developments and constantly maintain their skills in airway management.

This article reviews current knowledge of intubation and related aspects of airway management, emphasizing important developments in the past 5 to 10 years and focusing on translaryngeal intubation (TLI) in the adult patient who requires mechanical ventilation in a critical care unit. The reader is referred to an extensive review of critical care airway management published in Clinics in Chest Medicine in 1991<sup>72References 49, 58, 76, 113, 160, 161, 171, 173.

Cliquez ici pour aller à la section Références</sup> and other recent reviews.^{*References 49, 58, 76, 113, 160, 161, 171, 173.}

The authors first discuss new tools and techniques of airway management, including current concepts in management of the difficult airway. This is followed by a review of pharmacologic agents used to facilitate airway care, including agents for muscle relaxation and sedation. The authors also provide an update on complications of TLI, hoping that fresh insights into ways to avoid these adverse experiences will be gained. Extubation, a subject that often gets “short shrift” in the literature, then is reviewed, followed by a discussion of optimal timing of tracheotomy and an update on miscellaneous aspects of critical airway management.