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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Then using Seldinger technique the malleable wire Spring-Wire Guide: It was decided to use retrograde intubation technique in the present case due to the restricted mouth opening, and the difficulty to maintain a clear airway with the submandibular incision bleeding or other invasive manipulation. Submental intubation combines the advantages of nasotracheal intubation, which allows the mobilization of the dental occlusion, and those of orotracheal intubation, which allows access to naso-orbito-ethmoidal fractures Caubi et al.
Endotracheal tube in position fixed to retrogrsda. Guide wire insertion through cricothyroid membrane; B. Perimortem intracranial orogastric tube in pediatric trauma patient with a basilar skull fracture.
Throat pack was retrogeada. Nevertheless, we report for the first rstrograda the retrograde submental intubation technique using direct video laryngoscopy. The tented oral mucosa was incised to make a small opening and the blades of the hemostat were opened to allow the entrance of the reinforced endotraqueal tube.
At the end of the surgery the tube was disconnected, pulled back into the oral cavity and reconnected. Further clinical examination did not reveal any other traumatic injury.
In conclusion, submental intubation is a safe and effective technique for establishing a secure airway in patients requiring facial reconstructive surgery where traditional oral and nasotracheal intubation are contraindicated. The intubaciin reassures the adequate end tidal carbon dioxide curve and auscultation of the chest for correct position of the tube.
The management of a difficult airway is one of the biggest challenges of perioperative anesthesia management.
Very low rates of complications have been reported. There have been several articles in the literature describing and modifying the technique Altemir; Jundt et al.
The connector and breathing system were reattached and the cuff reinflated. Communication between the surgeon and anesthesiologist is extremely important for the safety of the patient and the success of the procedure. Mandible border blue lineskin incision yellow linecenter region of geniohyoid and genioglossus muscles red area ; Intubaciom.
Reinforced endotracheal tube fixed to skin. 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, ineligible for nasotracheal intubation due to the potential risk of creating a false passage to the cranial cavity Jundt et al.
In comparing submental intubation and tracheostomy, submental intubation has no significant reported major complications Jundt et al. The limitation of this technique is for patients who also present a neurological deficit or thoracic regrograda and need more than 7 days of postoperative ventilator support Jundt et al.
In addition, the surgical anatomy of the technique is detailed described. In such cases a tracheostomy is the indicated procedure. Retrograde submental intubation by pharyngeal loop technique in a patient with faciomaxillary trauma and restricted mouth opening.
Many features make the submental intubation very useful in several clinical scenarios including craniomaxillofacial trauma, orthognathic surgery and pathology.
After preoxygenation and intravenous induction of anesthesia, submental region and anterior neck is disinfected and draped as usual sterile fashion. The maxillofacial trauma can cause serious disturbances of the soft and hard tissues of the anatomical components of the upper airway and often with little external evidence of deformity Arya et al.
The patient had suffered trauma to the midface.
A closed Kelly hemostatic forceps was introduced through the incision until the tip of the hemostat tented the mucosa of the floor of the mouth staying close to the lingual surface of mandible and lateral to the sublingual caruncle to avoid injury to the submandibular duct and lingual nerve. 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.
Afterwards the pilot balloon was grasped with the hemostat and pulled out gently through the passage, then the hemostat was reinserted through the passage to grasp the proximal end of the endotracheal tube to be brought out with controlled rotational movements. San Juan, Puerto Rico.
Additional research is necessary to validate new modifications reported in the literature. 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.
In addition, the surgical anatomy of the technique is described in detail.