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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Alba Bombarelli on Prezi

The connector and breathing system were reattached and the cuff reinflated. Extraorally the wound was sutured and the patient was extubated without complications. Then using Seldinger technique the malleable wire Spring-Wire Jntubacion In such cases a tracheostomy is the indicated procedure.

The endotracheal tubes now lies on the floor of the mouth between the tongue and the mandible. Retroyrada intubation versus tracheostomy. University of Infubacion Rico. However, adequate mouth opening is a prerequisite for the technique. Many features make the submental intubation very useful in several clinical scenarios including craniomaxillofacial trauma, orthognathic surgery and pathology.

The management of a difficult airway is one of the biggest challenges of perioperative anesthesia management. In our case where the patient only presented midface isolated trauma with retrogada of intubaciom intermaxillary fixation, submental intubation was the correct choice for intraoperative airway.

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. 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.

Guide wire insertion through cricothyroid membrane; 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.

Further clinical examination did not reveal any other traumatic injury. Each technique has its indications with advantages and disadvantages. In addition, the surgical anatomy of the technique is described in detail. Since the first application of this technique, less than thirty years ago, many authors have studied the clinical use of this procedure.


Additional research is necessary to validate new modifications reported in the literature. Nevertheless, we report for the first time the retrograde submental intubation technique using direct video laryngoscopy. The breathing circuit is briefly disconnected as intubaxion tube is externalized and reconnected to the circuit and then secured to the patient Fig.

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.

Perimortem intracranial orogastric tube in pediatric trauma patient with a basilar skull fracture. 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.

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.

Finally, the endotracheal tube is fixed to skin with sutures to prevent accidental displacement Fig. The patient had suffered trauma to the midface.

In addition, the surgical anatomy of the technique rterograda detailed described. 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. Many trials have shown the submental route to be a simple, quick and safe approach to airway management Caubi et al.

On initial evaluation the patient was in non-acute distress, alert, awake and oriented, with a Glascow coma score of 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 intubaciln. In conclusion, submental intubation is a safe and effective technique for establishing a secure airway in patients requiring facial reconstructive surgery where retrpgrada oral and nasotracheal intubation are contraindicated.


Alba Bombarelli

At the end of the surgery the tube was disconnected, pulled back into the oral cavity and reconnected. Pasaje Republica de Honduras interior San Juan, Puerto Rico.

Submental intubation or its intubaciob as retrograde submental intubation was first described in a patient with restricted mouth opening by Arya 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.

The endotracheal tube was disconnected from the breathing circuit and retrogrda connector removed the anesthesiologist stabilized at this moment the endotracheal tube with Magill’s forceps to avoid rerograda. Mandible border blue lineskin incision yellow linecenter region of geniohyoid and genioglossus muscles red area intubacioon B.

In choosing a potential modification, the surgeon should inform the anesthesiologist of their intended sequence. 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 retrogradz nasotracheal intubation.

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. Several airway management techniques have been described, including: Submental intubation in oral maxillofacial surgery: Radiologic examination confirmed the presence of Le Fort II fracture, naso-orbitoethmoid fracture, bilateral zygomaticomaxillary complex fractures and left mandible subcondylar fracture.

The mortality rate of tracheostomy retrogradx been reported to range from 0. The anesthesiologist reassures the adequate end tidal carbon dioxide curve and auscultation of the chest for correct position of the tube.

After preoxygenation and intravenous induction of anesthesia, submental region and anterior neck is disinfected and draped as usual sterile fashion. There was midface mobility, malocclusion and mouth opening was restricted. The open reduction and internal fixation regrograda the facial fractures could then be performed as planned and the occlusion checked with intermaxillary fixation.