Request PDF on ResearchGate | On Jan 1, , Teresa López Correa and others published Intubación retrógrada. Acceso quirúrgico a la vía aérea. May 18, ·. INTUBACIÓN RETROGRADA. Views. 8 Likes15 Shares · Share. English (US) · Español · Português (Brasil) · Français (France) · Deutsch. intubacion retrograda tecnica pdf. Quote. Postby Just» Tue Aug 28, am. Looking for intubacion retrograda tecnica pdf. Will be grateful for any help!.
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The appropriate reinforced endotracheal tube size was passed which connector was previously removed through with the malleable intubaciln as guidance, when the distal end of the endotracheal tube meets the resistance at the level of the cricothyroid membrane against the wirethe wire was cut at the puncture site and the endotracheal tube passed, the remaining wire removed through the tube.
Retrograde submental intubation by pharyngeal loop technique in a patient with faciomaxillary trauma and restricted mouth opening. In comparing submental intubation and tracheostomy, submental intubation has no significant reported major complications Jundt et al.
The maxillofacial trauma can cause serious disturbances of retorgrada soft and hard tissues of the anatomical components of the upper airway and often with little external evidence of deformity Arya et al. Examination of the face revealed periorbital and nasal swelling, traumatic telecanthus, nasal deformity, epistaxis and bilateral subconjuntival hemorrhage. In addition to fewer reported minor complications infection, fistula, hypertrophic scarring, mucocelesubmental intubation requires less time than a tracheostomy, costs less and results in an aesthetically well tolerated scar Jundt et al.
Many features make the submental intubation very useful in several clinical scenarios including craniomaxillofacial trauma, orthognathic surgery and pathology.
In such cases a tracheostomy is the indicated procedure. Throat pack was placed.
The patient had suffered trauma to the midface. Then using Seldinger technique the malleable wire Spring-Wire Guide: Radiologic examination confirmed the presence of Le Fort II fracture, naso-orbitoethmoid fracture, bilateral zygomaticomaxillary complex fractures and left mandible subcondylar fracture. On initial evaluation the patient was in non-acute distress, alert, awake and oriented, with a Glascow coma score of Mandible border blue lineskin incision yellow linecenter region of geniohyoid and genioglossus muscles red area ; B.
The management of a difficult airway is one of the biggest challenges of perioperative anesthesia management. The original surgical procedure consists in the externalization of the endotracheal tube from the mouth through the floor of the mouth and the submental triangle. The submental intubation is a procedure that was reported to avoid tracheostomy and allow for the concomitant restoration of occlusion and reduction of facial fractures in patients with craniomaxillofacial trauma ineligibles for nasotracheal intubation.
Endotracheal tube in position fixed to skin.
intubacion retrograda tecnica pdf – PDF Files
The endotracheal tube was disconnected from the breathing circuit and the connector removed the anesthesiologist stabilized at this moment the endotracheal tube with Magill’s forceps to avoid extubation. Many trials have shown the submental route to be a simple, quick and safe approach to airway management Caubi et al. This technique was first described in by Francisco Hernandez Altemir and since its first description 10 articles have been published outlining modifications to the original technique primarily aimed at reducing complications Altemir, ; Jundt et al.
Nevertheless, we report for the first time the retrograde submental intubation technique using direct video laryngoscopy. Guide wire insertion through cricothyroid membrane; B. Guide wire red dotted line passed through larynx to oral cavity; B. Several airway management techniques have been described, including: The limitation of this technique is for patients who also present a neurological deficit or thoracic trauma and need more than 7 days of postoperative ventilator support Jundt et al.
Intubación retrograda modificada
Additional research is necessary to validate new modifications reported in the literature. Perimortem intracranial orogastric tube in pediatric trauma patient with a basilar skull fracture. A closed Kelly hemostatic forceps was introduced through retrpgrada incision until the tip of the hemostat tented the mucosa of the floor of the mouth retrogrda close to the lingual surface of mandible and lateral to the sublingual caruncle to avoid injury to the submandibular duct and lingual nerve.
The Insertion of the wire guide through the cricothyroid membrane helps to place correctly the endotracheal tube and also counting with the assistance of the direct video laryngoscopy, where the complete mouth opening is not necessary. Reinforced endotracheal tube fixed to skin. There have been several articles in the literature describing and modifying the technique Altemir; Jundt et al.
We described a modification of the original technique by performing a retrograde submental intubation assisted by direct laryngoscope video in a maxillofacial trauma patient with restricted mouth opening.
Finally, the endotracheal tube is fixed to skin with sutures to prevent accidental displacement Fig.
The breathing circuit is briefly disconnected as the tube is externalized and reconnected to the circuit and then secured to the patient Fig. Communication between the surgeon and anesthesiologist is extremely important for the safety of the patient and retrrograda success of the procedure. The anesthesiologist reassures the adequate end tidal carbon dioxide curve and auscultation of the chest for correct position of the tube.
The main objective of this study is to describe a modification of the original technique by performing a retrograde submental intubation assisted by direct laryngoscope video in a maxillofacial trauma patient with restricted mouth opening.
The submental route for endo-tracheal intubation. The open reduction and internal fixation of the facial fractures could then be performed as planned and the occlusion checked with intermaxillary fixation. In our case where the patient ertrograda presented midface isolated trauma with need of intraoperative intermaxillary fixation, submental intubation was the correct choice for intraoperative airway.
There was midface mobility, malocclusion and mouth opening was restricted. University of Puerto Rico. After preoxygenation and intravenous induction of anesthesia, submental region and anterior neck is disinfected and draped as usual sterile fashion.