The difficult airway: A safe extubation strategy.

During the last years, different algorithms have been developed for the treatment of a difficult airway, which besides the development of new technologies such as video laryngoscopy, have improved the results in the treatment of these patients. However, all of it has not had beneficial repercussions on the complications derived from extubation, especially in difficult patients, who remain in a third of the total complications related to the control of the airway, reaching a mortality rate of 5%. We all know the clinical criteria for extubation in a patient. However, it is mandatory to have previously established an adequate strategy to perform a safe extubation for our patient, especially if it was difficult to intubate. In this review, we will analyze the clinical or pathophysiological conditions associated with an increased risk of failed extubation and discuss the different strategies available, as well as the importance of adequate training in techniques and devices to successfully develop these safe extubation strategies.