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 open reduction and internal fixation of the facial fractures could then be performed as planned and the occlusion checked with intermaxillary fixation.
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. Perimortem intracranial orogastric tube in pediatric trauma patient with a basilar skull fracture. Afterwards the pilot balloon was grasped with the hemostat and pulled out gently through the passage, then the hemostat was reinserted through retrlgrada passage to grasp the proximal end of the endotracheal tube to be brought out with controlled rotational movements.
Intracranial malposition of nasopharyngeal airway.
Many trials have shown the submental route to be a simple, quick and safe approach to airway management Caubi et al. 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.
Guide wire insertion through cricothyroid membrane; B. Throat pack was placed. Nevertheless, we report for the first time the retrograde submental intubation technique using direct video laryngoscopy. Many features make the submental intubation very useful in several clinical scenarios including craniomaxillofacial trauma, orthognathic surgery and pathology. 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 patient had suffered trauma to the midface. Further clinical examination did not reveal any other traumatic injury.
Retrograde submental intubation by pharyngeal loop technique in a patient with faciomaxillary trauma and restricted mouth opening. 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. 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.
intubacion retrograda tecnica pdf – PDF Files
The submental route for endo-tracheal intubation. The management of a difficult airway is one of the biggest challenges of perioperative anesthesia management. Examination of the face revealed periorbital and nasal swelling, traumatic telecanthus, nasal deformity, epistaxis and bilateral subconjuntival hemorrhage. Reinforced endotracheal tube fixed to skin. Then using Seldinger technique the malleable wire Spring-Wire Guide: Radiologic examination confirmed the presence of Intjbacion Fort II fracture, naso-orbitoethmoid fracture, bilateral zygomaticomaxillary complex fractures and left mandible subcondylar fracture.
Very low rates of complications have been reported. A closed Kelly hemostatic forceps was introduced rettrograda the incision until the tip of the hemostat tented the mucosa intubaciln 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. Each technique has its indications with advantages and disadvantages. The endotracheal tube was secured and adequate end tidal carbon dioxide curve was observed.
Mandible border blue lineskin incision yellow linerefrograda region of geniohyoid and genioglossus muscles red area ; B. In such cases detrograda tracheostomy is the indicated procedure. There was midface mobility, malocclusion and mouth opening was restricted.
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. The endotracheal tubes now lies on the floor of the mouth between the tongue and the mandible. Additional research is necessary to validate new modifications reported in the literature.
Communication between the surgeon and anesthesiologist is extremely important for the safety of the patient and the success of the procedure. Retrograca preoxygenation and intravenous induction of anesthesia, submental region and anterior neck is disinfected and draped as usual sterile fashion.
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. Technical Note and Case Report. At the end of the surgery the tube was disconnected, pulled back into the oral cavity and reconnected.
On initial evaluation the patient was in non-acute distress, alert, awake and oriented, with a Glascow coma score of Pasaje Republica de Honduras interior In our case where the patient only presented midface isolated trauma with need of intraoperative intermaxillary fixation, submental intubation was the correct choice for intraoperative airway.
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. Submental intubation versus tracheostomy. The anesthesiologist reassures the adequate end tidal carbon dioxide curve and auscultation of the chest for correct position of the tube.
The mortality rate of tracheostomy has been reported to range from 0.