INTUBACION RETROGRADA PDF
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 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. In choosing a potential modification, the surgeon should inform the anesthesiologist of their intended sequence.
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. On initial evaluation the patient was in non-acute distress, alert, awake and oriented, with a Glascow coma score of 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.
In addition, the surgical anatomy of the technique is detailed described. Radiologic examination confirmed the presence of Le Fort II fracture, naso-orbitoethmoid fracture, bilateral zygomaticomaxillary complex fractures and left mandible subcondylar fracture. 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.
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. 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.
In addition, the surgical anatomy of the technique is described in detail. 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.
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Many trials have shown the submental route to be a simple, quick and safe approach to airway management Caubi et al. Communication between the surgeon and anesthesiologist is extremely important for the safety of the patient and the success of the procedure. The anesthesiologist reassures the adequate end tidal carbon rterograda curve and auscultation of the chest for correct position of the tube.
Guide wire insertion through cricothyroid membrane; B. In our case where the patient only presented midface isolated trauma with need of intraoperative intermaxillary fixation, submental intubation was the correct choice for retrograds airway.
Endotracheal tube in position fixed to skin. In a literature review conducted by Jundt et al. Reinforced endotracheal tube fixed to skin.
Very low rates of complications have been reported. After preoxygenation and intravenous induction of anesthesia, submental region and anterior intkbacion is disinfected and draped as usual sterile fashion. The open reduction and internal fixation of the facial fractures could then be performed as planned and the occlusion checked with intermaxillary fixation.
Mandible border blue lineskin incision yellow linecenter region of geniohyoid and genioglossus muscles red area ; B. It was decided to use intubcaion intubation technique in the present case due to the restricted mouth opening, and the difficulty to maintain a clear airway with the submandibular retrogrwda bleeding or other invasive manipulation. Submental intubation in oral maxillofacial surgery: Technical Note and Case Report.
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.
There was midface mobility, malocclusion and mouth opening was restricted.
Guide wire red dotted line passed through larynx to oral cavity; B. 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 retrgorada, ineligible for nasotracheal intubation due to the potential risk of creating a false passage to the cranial cavity Jundt et al. Throat pack was placed.
intubacion retrograda tecnica pdf
Finally, the endotracheal tube is fixed to skin with sutures to prevent accidental displacement Fig. The submental route for endo-tracheal intubation. Examination of the face revealed periorbital and nasal swelling, traumatic telecanthus, nasal deformity, epistaxis and bilateral subconjuntival hemorrhage. There have been several articles in the literature describing and modifying the technique Altemir; Jundt et al. The breathing circuit is briefly disconnected as the tube is externalized and reconnected to the circuit and then secured to the patient Fig.
Perimortem intracranial orogastric tube in pediatric trauma patient with a basilar skull fracture. However, adequate mouth opening is a prerequisite for the technique. Submental intubation or its modification as retrograde retrkgrada intubation ingubacion first described in a patient with restricted mouth opening by Arya et al. A skin incision of 2 cm retrigrada 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.