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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A skin incision of 2 cm in the submental, paramedian region and with blunt dissection toward the floor of mouth until the mucosa was tented with a hemostat after which another 2 cm incision is made in the mucosa Fig.
Guide wire red dotted line passed through larynx to oral cavity; B. 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. Perimortem intracranial orogastric tube in pediatric trauma patient with a basilar skull fracture. Endotracheal tube in position fixed to skin. Communication between the surgeon and anesthesiologist is extremely important for the safety of the patient and the success of the procedure.
The appropriate reinforced endotracheal tube size was passed which connector was previously removed through with the malleable wire 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.
Guide wire insertion through cricothyroid membrane; B. The open reduction and internal fixation of the facial fractures could then be performed as planned and the occlusion checked with intermaxillary fixation.
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. Reinforced endotracheal tube fixed to skin. The patient had suffered trauma to the midface. Submental intubation versus tracheostomy.
INTUBACION RETROGRADA – VIA AEREA DIFICIL ECARRILLO
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. However, adequate mouth opening is a prerequisite for the technique.
Extraorally the wound was sutured and the patient was extubated without complications. The breathing circuit is briefly disconnected as the tube is externalized and reconnected to the circuit and then secured to the patient Fig. 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.
intubacion retrograda tecnica pdf – PDF Files
Retrograde submental intubation by pharyngeal loop technique in a patient with faciomaxillary trauma and restricted mouth opening. The submental route for endo-tracheal intubation. In addition, the surgical anatomy of the technique is described in detail.
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.
After preoxygenation and intravenous induction of anesthesia, submental region and anterior neck is disinfected and draped as usual sterile fashion. Mandible border blue lineskin incision yellow linecenter region of geniohyoid and genioglossus muscles red area ; B. Finally, the endotracheal tube is fixed to skin with sutures to prevent accidental displacement Fig.
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 tented oral mucosa was incised to make a rdtrograda opening and the blades of the hemostat were opened to allow the entrance of the reinforced endotraqueal tube. On initial evaluation the patient was itnubacion non-acute distress, alert, awake and oriented, with a Glascow coma score of The anesthesiologist reassures the adequate end tidal carbon dioxide curve and auscultation of the chest for correct position of the tube.
Submental intubation in oral maxillofacial surgery: Throat pack was placed. Many trials have shown the submental route to intubafion a simple, quick and safe approach to airway management Caubi et al. 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.
intubacion retrograda tecnica pdf
There have been several articles in the literature describing and modifying the technique Altemir; Jundt et al. Examination of the face revealed periorbital and nasal swelling, traumatic telecanthus, nasal deformity, epistaxis and bilateral subconjuntival hemorrhage. Each technique has its indications with advantages and disadvantages.
Several airway management techniques have been described, including: In such cases a tracheostomy is the indicated procedure.
This technique was first described in by Francisco Hernandez Altemir and since its first description 10 articles have retrogada published outlining modifications to the original technique primarily aimed at reducing complications Altemir, ; Jundt et al.
San Juan, Puerto Rico. The endotracheal tube was secured and adequate end tidal carbon dioxide curve was observed.
Additional research is necessary to validate new modifications reported in the literature.