Small Patients, Big Risk

The pediatric airway presents significant physiological challenges that make children particularly susceptible to adverse events during intubation. These vulnerabilities place them at increased risk for cardiovascular collapse and cardiac arrest during airway procedures. Hypoxemia and hypotension are the most frequent adverse events in this population. To reduce these risks, strategies to enhance preoxygenation and apneic oxygenation, as well as optimizing hemodynamic status before intubation, are critical to improving the safety of pediatric emergency airway management. This review highlights the concept of the physiologically difficult airway in children, outlines risk factors associated with physiological deterioration, and proposes interventions to mitigate these risks.