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Open research questions in Airway Management and Intubation Techniques

127 unresolved questions extracted from the limitations and future-work sections of 737 Airway Management and Intubation Techniques papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Postoperative atelectasis is a major cause of respiratory complications during general anesthesia. Lung-protective ventilation has limited benefits in laparoscopy. The use of LMA may be associated with increased risk of air leak and other complications.

    Laryngeal mask airway versus endotracheal tube for preventing postoperative atelectasis after laparoscopic surgery: a randomized controlled trial · 2026 · DOI

  • Further studies are needed to investigate the long-term effects of LMA use on postoperative atelectasis. Studies should be conducted to compare the effectiveness of LMA and ETT in different surgical procedures. Research should be done to develop clinical guidelines for the prevention of postoperative atelectasis.

    Laryngeal mask airway versus endotracheal tube for preventing postoperative atelectasis after laparoscopic surgery: a randomized controlled trial · 2026 · DOI

  • The complexity of the BMV process - The need for careful consideration of varying factors such as airway patency and compliance

    Bag-Mask Ventilation Is Basic—Or Is It? · 2026 · DOI

  • The effectiveness of HFNC and NIV in preventing severe hypoxemia during intubation is unclear. There is a need to compare the two pre-oxygenation strategies in patients with acute hypoxemic respiratory failure.

    The best modality of pre-oxygenation between high-flow nasal cannula and non-invasive ventilation during intubation of acute hypoxemic respiratory failure patients · 2026 · DOI

  • Gaps in pediatric airway management practice and safety - Underuse of RSI and reliance on anesthesiologists

    Evolution in pediatric emergency airway management over a decade at a tertiary center in Pakistan · 2026 · DOI

  • The optimal anesthetic protocol for flexible fiberoptic bronchoscopy in pediatric patients is unclear. There is a need for studies investigating the use of low-dose rocuronium as an adjuvant to remifentanil.

    Low-dose rocuronium as an adjuvant to remifentanil for laryngeal mask airway-assisted flexible fiberoptic bronchoscopy in children: protocol for a randomized placebo-controlled trial · 2026 · DOI

  • Interruption of gas exchange for even a few minutes can result in catastrophic outcomes. Almost one third of deaths attributable to anesthesia have been related to inability to maintain a patent airway. Various clinical criteria used to predict difficult airway have limited sensitivity and specificity.

    Use of ultrasonography as a novel tool of airway assessment in patients undergoing general anesthesia and surgery and its comparison with Cormack-Lehane classification: a prospective observational study · 2026 · DOI

  • Accurate preoperative prediction of difficult airway remains a challenge in anesthetic practice. Conventional bedside airway assessment tests have limited sensitivity and specificity.

    Use of ultrasonography as a novel tool of airway assessment in patients undergoing general anesthesia and surgery and its comparison with Cormack-Lehane classification: a prospective observational study · 2026 · DOI

  • Overinflation of the cuff can compress the pharyngolaryngeal mucosa, causing local tissue ischemia, edema, and even nerve injury. The lack of routine monitoring and standardized safe thresholds for ILMA cuff pressure.

    Individualized regulation of inflatable laryngeal mask airway cuff pressure reduces postoperative pharyngolaryngeal pain in elderly patients: a randomized controlled trial · 2026 · DOI

  • The lack of routine monitoring and standardized safe thresholds for ILMA cuff pressure. The need for an individualized ILMA cuff pressure regulation strategy based on physiological characteristics and sealing principles.

    Individualized regulation of inflatable laryngeal mask airway cuff pressure reduces postoperative pharyngolaryngeal pain in elderly patients: a randomized controlled trial · 2026 · DOI

  • Information is limited on the correct technique and use of Magill forceps for removal of a foreign body obstructing the airway. There is not a widely accepted standard or protocol for their use in EMS.

    Determination of Optimal Magill Forceps Hand Position and Laryngoscope Type to Remove a Simulated Foreign Body Airway Obstruction · 2026 · DOI

  • There are several limitations to this study. Because removal of a foreign body for airway obstruction is a rare procedure in the field, a training model was used. The use of manikins for this study limits external validity, given the variable and diverse presentations of foreign bodies causing airway obstruction that are seen in the field. The model used was reproducible to allow for accurate comparison; however, the composition of a true foreign body can be highly variable, and the use of a cork may not approximate real foreign bodies that are slippery and more difficult to grasp. To ensure standardization, the manikin’s head was placed in a neutral position prior to beginning the procedure. It is possible that neutral positioning could affect airway axis alignment and the ease of using direct laryngoscopy, although the paramedic could manually reposition the head to improve alignment. In addition, removal of a foreign body for airway obstruction is typically done on the floor, while this training was done with the manikin positioned on a table. Measurement bias may have been introduced by using an unblinded timing device. Additionally, hand positioning data was incomplete from year 1, as data was not collected for the entire cohort, prior to identifying its importance. Also, it is possible that a small number of paramedics did not receive the educational intervention due to employee turnover. Although this study does not include patient-oriented outcomes, it can serve as a step toward establishing a standardized technique for the use of Magill forceps.

    Determination of Optimal Magill Forceps Hand Position and Laryngoscope Type to Remove a Simulated Foreign Body Airway Obstruction · 2026 · DOI

  • One challenge is the limited availability of human cadavers for research purposes. Another challenge is the need for a controlled laboratory setting to evaluate ventilatory performance.

    Comparison of ventilation with second-generation supraglottic airway devices in a prospective randomized cadaver study · 2026 · DOI

  • Malpositioning of ScBB can lead to interruptions during surgery. The use of ScBB may compromise the success of thoracoscopic lobectomy. There is a need for alternative airway management techniques that can reduce malpositioning.

    Double-cuff versus single-cuff bronchial blockers for video-assisted thoracoscopic lobectomy: A randomized controlled trial · 2026 · DOI

  • Limited evidence supporting any one airway management technique in a prehospital environment. The need for effective airway management in patients with potential cervical spine injury. The challenge of minimizing cervical spine movement during intubation.

    Letter to the Editor: Optimal device for emergency intubation - a commentary on the complementary role of intubating laryngeal mask airway-video laryngoscope · 2026 · DOI

  • The study was conducted in a simulated environment. The study had a limited sample size of 64 participants. The study did not include a washout period between the two intubation methods.

    Letter to the Editor: Optimal device for emergency intubation - a commentary on the complementary role of intubating laryngeal mask airway-video laryngoscope · 2026 · DOI

  • The paper identifies several challenges, including failure to treat preintubation hypotension, failure to identify patients with pulmonary hypertension or RV failure, and the risk of hemodynamic collapse from high intrathoracic pressure caused by air trapping. The authors also discuss the challenge of managing patients with severe metabolic acidosis and the need for careful consideration of patient physiology and comorbidities during intubation.

    Letter to the Editor: Insight into emergency endotracheal intubation in critically ill and strategies beyond equipment · 2026 · DOI

  • The paper identifies a gap in the current understanding of emergency endotracheal intubation, including the need for strategies beyond equipment. The authors emphasize the importance of considering patient physiology and comorbidities during intubation.

    Letter to the Editor: Insight into emergency endotracheal intubation in critically ill and strategies beyond equipment · 2026 · DOI

  • There is a need for alternative airway devices that can provide effective ventilation with minimal airway trauma. The Baska mask has emerged as a potential alternative to endotracheal intubation.

    A Comparative Study of Endotracheal Intubation Versus Baska Mask in Laparoscopic Surgery Under General Anaesthesia with Controlled Ventilation · 2026 · DOI

  • The scarcity of patients and procedures in pediatric airway management necessitates the use of simulations. The limited exposure of residents and young physicians to real pediatric intubations is a significant gap. The paper identifies the need for high-fidelity simulations to replicate complex clinical scenarios, including emergency situations.

    High Fidelity Simulations to Improve Pediatric Airway Management: A Narrative Review · 2026 · DOI

  • Wider implementation requires outcome-based evidence, focused training, and integration into structured difficult airway pathways. The evidence remains less mature for certain applications, such as airway device decisions. The value of ultrasound is not that it replaces existing tools, but that it can add a bedside anatomical layer to decisions.

    Airway ultrasound in patients undergoing head and neck surgery · 2026 · DOI

  • Conventional bedside predictors may be unreliable when anatomy is distorted. There is a need for a more effective approach to airway management planning in head and neck surgery.

    Airway ultrasound in patients undergoing head and neck surgery · 2026 · DOI

  • AI is expected to play an increasingly important role in airway management as computational capabilities, data availability, and algorithm performance continue to improve. Although current applications are primarily focused on difficult airway prediction and procedural support, future developments may transform multiple aspects of airway assessment, decision-making, training, and clinical practice. One of the most promising future applications is the development of multimodal predictive systems that integrate diverse sources of patient information. Current airway assessment methods often rely on individual clinical parameters or isolated imaging findings. Future AI platforms may combine demographic characteristics, facial photographs, voice recordings, ultrasound images, radiological data, electronic health records, and physiological measurements into a single predictive framework. Such comprehensive models could provide highly personalized risk assessments and improve the identification of patients at risk for difficult airway management. [19-21] Advances in computer vision and DL are also likely to enhance real-time airway guidance during videolaryngoscopy and tracheal intubation. Future AI-enabled videolaryngoscopes may automatically 2026 Ashraf et al. Cureus 18(6): e110566. DOI 10.7759/cureus.110566 7 of 12 identify airway structures, assess glottic visualization, verify endotracheal tube placement, and provide immediate procedural recommendations. Integration of augmented reality technology may allow anatomical landmarks and guidance prompts to be projected directly onto the operator’s display, potentially improving first-pass intubation success and reducing complications. [22-24] Ultrasound-based airway assessment represents another area of significant future potential. Automated image interpretation systems may simplify airway ultrasonography and reduce operator dependency. AI algorithms capable of real-time analysis of airway anatomy could facilitate rapid bedside assessment, particularly in emergency and critical care settings. As portable ultrasound devices become increasingly available, integration with AI may expand access to advanced airway evaluation tools. [26] AI may also contribute to the development of intelligent clinical decision-support systems. Such platforms could assist clinicians in selecting appropriate airway management strategies based on patient-specific characteristics and current clinical guidelines. During high-stress situations, AI systems may function as cognitive aids by providing reminders, risk alerts, and evidence-based recommendations. These tools have the potential to reduce human error and improve adherence to established airway management algorithms. The future may also witness the emergence of robotic and semi-autonomous airway management systems. Experimental studies have already demonstrated the feasibility of AI-guided robotic intubation under controlled conditions. Although widespread clinical implementation remains distant, advances in robotics, ML, and computer vision may eventually enable remote airway interventions and support airway management in resource-limited environments. In medical education, AI-powered simulation platforms are expected to become increasingly sophisticated. Adaptive learning systems capable of tailoring educational content to individual learner needs may improve training efficiency and competency development. Virtual reality and augmented reality technologies integrated with AI-driven feedback systems may provide highly realistic and personalized learning experiences for airway management trainees. Despite these exciting possibilities, future progress will depend on addressing several important challenges. Large multicentre studies are needed to validate existing models across diverse populations and clinical settings. The development of explainable AI frameworks will be essential to improve transparency and clinician trust. Regulatory oversight, ethical governance, and robust data security measures must evolve alongside technological advances to ensure safe and responsible implementation. Ultimately, the future of AI in airway management is unlikely to involve the replacement of clinicians. Instead, AI is expected to function as a powerful adjunct that complements human expertise by enhancing prediction, improving decision-making, supporting procedural performance, and facilitating education. The most effective airway management strategies will likely arise from collaboration between skilled clinicians and intelligent technological systems. Emerging applications and future directions of AI in airway management are summarized in Table 3.

    Artificial Intelligence in Airway Management: Current Evidence and Future Perspectives · 2026 · DOI

  • There is a lack of standardized decannulation protocols for patients with prolonged disorders of consciousness after brain injury. Existing decannulation strategies may not be suitable for this population.

    A stepwise decannulation pathway for patients with prolonged disorders of consciousness after brain injury: a retrospective feasibility study · 2026 · DOI

  • There is a need for alternative anesthetic techniques in high-risk airway patients. General anesthesia with tracheal intubation may be unsafe in these patients.

    A High-Risk Airway Patient Undergoing Open Gastrostomy Under Subcostal Tap Block: A Case Report · 2026 · DOI

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127 open questions have been extracted from the limitations and future-work passages of 737 Airway Management and Intubation Techniques papers in our library. Each one below links back to the study that raised it, so you can read the original claim in context.

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