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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Intubación retrograda modificada

Reinforced endotracheal tube fixed to skin. The main retroggada of this study is to describe a modification of the original technique by performing a retrograde submental intubation assisted by direct intubacuon video in a maxillofacial trauma patient with restricted mouth opening.

Radiologic examination confirmed the presence of Le Fort II fracture, naso-orbitoethmoid fracture, bilateral zygomaticomaxillary complex fractures and left mandible subcondylar fracture. The endotracheal tube was secured and adequate end tidal carbon dioxide curve was observed. Since the first application of this technique, less than thirty years ago, many authors have studied the clinical use of this procedure. The management of a difficult airway is one of the biggest challenges of perioperative anesthesia management.

The endotracheal tube was disconnected from the breathing intubxcion and the connector removed the anesthesiologist stabilized at this moment the endotracheal tube with Magill’s forceps to avoid extubation.

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.

intubacion retrograda tecnica pdf

Additional research is necessary to validate new modifications reported in the literature. Mandible border blue lineskin incision yellow linecenter region of geniohyoid and genioglossus muscles red area ; B. 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.


Many trials have shown the submental route to be a simple, quick and safe approach to airway management Caubi et al. There have been several articles in the literature describing and modifying the technique Altemir; Jundt et al.

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. 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 retrograd the mouth between the tongue and the mandible.

The submental route for endo-tracheal intubation. 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. intbacion

The submental intubation is a procedure that was reported to avoid tracheostomy and allow for the intubacino restoration of occlusion and reduction of facial fractures in patients with craniomaxillofacial trauma ineligibles for nasotracheal intubation. San Juan, Puerto Rico. Each technique has its indications with advantages and disadvantages. In addition, the surgical anatomy of the technique is described in detail. In comparing submental intubation and tracheostomy, submental intubation has no significant reported major complications Jundt et al.

In addition, the surgical anatomy of the technique is detailed described. Many features make the submental intubation very useful in several clinical scenarios including craniomaxillofacial trauma, orthognathic surgery and pathology.

Very low rates rretrograda complications have been reported. We described a modification of the original technique by performing a retrograde submental retrograva assisted by direct laryngoscope video in a maxillofacial trauma patient with restricted mouth opening.


However, adequate mouth opening is a prerequisite for the technique. 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.

Further clinical examination did not reveal any other traumatic injury. There was midface mobility, malocclusion and mouth opening was restricted. Extraorally the wound was sutured and the patient was extubated without complications. In a literature review conducted by Jundt et al. 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.

University of Puerto Rico. The open reduction and internal fixation of the facial fractures could then be performed as planned and the occlusion checked with intermaxillary fixation.

Technical Note and Case Report. Perimortem intracranial orogastric tube in pediatric trauma patient with a basilar skull fracture. Endotracheal tube in position fixed to skin. Several airway management techniques have been described, including: In choosing a potential modification, the surgeon should inform the anesthesiologist of their intended sequence. The connector and breathing system were reattached and the cuff reinflated.

The mortality rate of tracheostomy has been reported to range from 0. This technique was first described in by Francisco Hernandez Altemir and since its first description 10 articles have been published outlining inutbacion to the original technique primarily aimed at reducing complications Altemir, ; Jundt et al. In such cases a tracheostomy is the indicated procedure. Then using Seldinger technique the malleable wire Spring-Wire Guide: