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 submental intubation is a procedure that was reported to avoid tracheostomy and allow for the concomitant restoration retrogrrada occlusion and reduction of facial fractures in patients with craniomaxillofacial trauma ineligibles for nasotracheal intubation.
Technical Note and Case Report. Examination of the face revealed periorbital and nasal swelling, traumatic telecanthus, nasal deformity, epistaxis and bilateral subconjuntival hemorrhage. 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 retrograsa surgical procedure consists in the externalization of the endotracheal tube from the mouth through the floor of the mouth and the submental triangle. Submental intubation in oral maxillofacial surgery: In addition to fewer reported minor complications infection, fistula, hypertrophic scarring, mucocelesubmental intubation requires less time than a tracheostomy, costs less refrograda results in an aesthetically well tolerated scar Jundt et al.
The patient had suffered trauma to the midface. Many features make the submental intubation very useful in several clinical scenarios including craniomaxillofacial trauma, orthognathic surgery and pathology. Extraorally the wound was sutured and the patient was extubated without complications.
In a literature review conducted by Jundt et al. In such cases a tracheostomy is the indicated procedure. Finally, the endotracheal tube is fixed to skin with sutures to prevent accidental displacement Fig.
The mortality rate of tracheostomy has been reyrograda to range from 0. The endotracheal tube was secured and adequate end tidal carbon dioxide curve was observed. 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.
Perimortem intracranial orogastric tube in pediatric trauma patient with a basilar skull fracture. Retrograde submental intubation by pharyngeal loop technique in a patient with faciomaxillary trauma and restricted mouth intubacin.
Intracranial malposition of nasopharyngeal intubafion. San Juan, Puerto Rico. There was midface mobility, malocclusion and mouth opening was restricted. Pasaje Republica de Honduras interior Several airway management techniques have been described, including: In our case where the patient only presented midface isolated trauma with need of intraoperative intermaxillary fixation, submental intubation was the getrograda choice for intraoperative airway.
Many trials have shown the submental route to be a simple, quick and safe approach to airway management Caubi et al.
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The submental route for endo-tracheal intubation. In choosing a potential modification, the surgeon should inform the anesthesiologist of their intended sequence. 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.
The management of a difficult airway is one of the biggest challenges of perioperative anesthesia management. There have been several articles in the literature describing and modifying the technique Altemir; Jundt et al. Communication between the surgeon and anesthesiologist is extremely important for the safety of the patient and the success of the procedure. Radiologic examination confirmed the presence of Le Fort II fracture, naso-orbitoethmoid fracture, bilateral zygomaticomaxillary complex fractures and left mandible subcondylar fracture.
The anesthesiologist reassures the adequate end tidal carbon dioxide curve and auscultation of the chest for correct position of the tube. Additional research is necessary to validate new modifications reported in the literature. The maxillofacial trauma can cause serious disturbances of the soft and hard tissues of the anatomical components of the upper airway and often with fetrograda external evidence of deformity.
The Insertion of the wire guide through the cricothyroid membrane helps to place correctly the endotracheal tube and also counting with the assistance of rtrograda direct video laryngoscopy, where the complete mouth opening is not necessary.
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. We described a modification of the original technique intubacio performing a retrograde submental intubation assisted by direct laryngoscope video in a maxillofacial trauma patient with restricted mouth opening.
Very low rates of complications have been reported. Further clinical examination did not reveal any other traumatic injury. Guide wire insertion through cricothyroid membrane; B. After preoxygenation and intravenous induction of anesthesia, submental region and anterior neck is disinfected and draped as usual sterile fashion.
Reinforced endotracheal tube fixed to skin. The breathing circuit is briefly disconnected as the tube is externalized and reconnected to rstrograda circuit and then secured to the patient Fig.
In addition, the surgical anatomy of the technique is described in detail.