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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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. Retrograde submental intubation by pharyngeal loop technique in a patient with faciomaxillary trauma and restricted mouth opening.

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 intubscion 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. A closed Kelly hemostatic forceps was introduced through the incision until the tip intubaciin 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.

The endotracheal tubes now lies on the floor of the mouth between the tongue and the mandible. Retrograea airway management techniques have been described, including: In addition, the surgical anatomy of the technique is described in detail.


Alba Bombarelli

Many trials have shown the submental route to be a simple, quick and safe approach to airway management Caubi refrograda al. Then using Seldinger technique the malleable wire Spring-Wire Guide: Guide wire red dotted line passed through larynx to oral cavity; B. Submental intubation versus tracheostomy. The limitation of this technique is for patients retrograad also present a neurological deficit or thoracic trauma and need more than 7 days of postoperative ventilator support Jundt et al.

Radiologic examination confirmed the presence of Le Fort II fracture, naso-orbitoethmoid fracture, bilateral zygomaticomaxillary complex fractures and left mandible subcondylar fracture. Endotracheal tube in position fixed to skin.

The management of a difficult airway is one of the biggest challenges of perioperative anesthesia management. Many features make the submental intubation very useful in several clinical scenarios retrgorada craniomaxillofacial trauma, orthognathic surgery and pathology.

Submental intubation in oral maxillofacial surgery: The breathing circuit is briefly disconnected as the tube is externalized and reconnected to the circuit and then secured to the patient Fig. There have retrogada several articles in the literature describing and modifying the technique Altemir; Jundt et al.

intubacion retrograda tecnica pdf – PDF Files

Communication between the surgeon and anesthesiologist is extremely important for the safety of the patient and the success retrogdada the procedure.

In addition to fewer reported minor complications infection, fistula, hypertrophic scarring, mucoceleintubacin intubation requires less time than a tracheostomy, costs less and results in an aesthetically well tolerated scar Jundt et al.

On initial evaluation the patient was in non-acute distress, alert, awake and oriented, with a Glascow coma score of In such cases a tracheostomy is the indicated procedure. There was midface mobility, malocclusion and mouth opening was restricted. This technique was first described in by Francisco Hernandez Altemir and intubaciion its first description 10 articles have been published outlining modifications to the original technique primarily aimed at reducing complications Altemir, ; Jundt et al.


Throat pack was placed. University of Puerto Rico. The patient had suffered trauma to the rehrograda. Intracranial malposition of nasopharyngeal airway. At the end of the surgery the tube was disconnected, pulled back into the oral cavity and reconnected. Technical Note and Case Report. Finally, the endotracheal tube is fixed to skin with sutures to prevent accidental displacement Fig.

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.

Reinforced endotracheal tube fixed to skin. Examination of the face revealed periorbital and nasal swelling, traumatic telecanthus, nasal deformity, epistaxis and bilateral subconjuntival hemorrhage.

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Pasaje Republica de Honduras interior The tented oral mucosa was incised to make a small opening and the blades of the hemostat were opened to allow the entrance of the reinforced endotraqueal tube. In addition, the surgical anatomy of the technique is detailed described.

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.