Airway management in patients living with obesity: best practice recommendations from the Society for Obesity and Bariatric Anaesthesia: Endorsed by the All Wales Airway Group, Scottish Airway Group and Difficult Airway Society.

Abstract

Patients living with obesity present specific challenges for airway management. They have been overrepresented repeatedly in studies looking at complications associated with airway management. Whilst generic airway guidelines offer assistance, there are no evidence-based guidelines specific to this group of patients to support safe and effective airway management. An expert multidisciplinary working party was convened on behalf of the Society of Obesity and Bariatric Anaesthesia to conduct this work. A systematic review was performed and was followed by a three-round Delphi process. Forty-three recommendations are made which cover a number of key areas of practice including: pre-assessment; planning; peroxygenation; tracheal intubation; supraglottic airway devices; tracheal extubation; training; and organisational responsibilities. It is hoped the recommendations made will improve the safety and efficacy of airway management in patients living with obesity. They are not intended to replace current airway management guidelines.