Retrograde fiberoptic intubation
Abstract
This technical note aims to introduce a new approach for intubation of patients with restricted mouth opening in cases that conventional and fiberoptic-assisted endotracheal intubation are not possible. The proposed technique is a modification to the previously well-established retrograde intubation method. The main advantage of this new technique is the employment of fiberscope for direct visualization which eliminates the use of guide wire. The endotracheal tube enters through the nostril and is railroaded using the fiberscope as a guide. Using this new technique can prevent the complications of tracheostomy and the traditional retrograde intubation in patients that anterograde intubation is not feasible. The promising result of conducting the intubation with this approach can be considered the basis for future clinical investigation. Keywords: Fiberscope; Modified retrograde intubation; Direct visualization.
1. Weksler N, Klein M, Weksler D, et al. Retrograde tracheal intubation: beyond fibreoptic endotracheal intubation. Acta Anaesthesiol Scand 2004; 48: 412-6.
2. Dhara SS. Retrograde tracheal intubation. Anaesthesia 2009; 64: 1094-104.
3. Sawardekar A, Jagannathan N, Patel PK, Nadkarni A. Retrograde fiberoptic technique to avoid tracheostomy in a patient with a tracheocutaneous fistula and Treacher Collins syndrome. J Craniofac Surg 2011; 22: 255-6.
4. Butler FS, Cirillo A. Retrograde tracheal intubation. Anesth Analg 1960; 39: 333-8.
5. Barriot P, Riou B. Retrograde technique for tracheal intubation in trauma patients. Critical care medicine 1988; 16: 712-3.
6. Bhola N, Jadhav A, Borle R, Khemka G, ali Ajani A. Awake endotracheal retrograde intubation in restricted mouth opening: a ‘J’-tipped guide wire technique—a retrospective study. Oral Maxillofac Surg 2014; 18: 393-6.
7. Sanguanwit P, Trainarongsakul T, Kaewsawang N, Sawanyawisuth K, Sitthichanbuncha Y. Is retrograde intubation more successful than direct laryngoscopic technique in difficult endotracheal intubation? Am J Emerg Med 2016; 34: 2384-7.
8. Apfelbaum JL, Hagberg CA, Caplan RA, et al. Practice guidelines for management of the difficult airwayan updated report by the American Society of Anesthesiologists task force on management of the difficult airway. Anesthesiology 2013; 118: 251-70.
9. Wijesinghe HS, Gough JE. Complications of a retrograde intubation in a trauma patient. Academic Emerg Med 2000; 7: 1267-71.
10. Bowes WA, Johnson JO. Pneumomediastinum after planned retrograde fiberoptic intubation. Anesth Analg 1994; 78: 795-7.
11. Gill M, Madden MJ, Green SM. Retrograde endotracheal intubation: an investigation of indications, complications, and patient outcomes. Am J Emerg Med 2005; 23: 123-6.
12. Jain G, Singh DK, Yadav G, Gupta SK, Tharwani S. A modification in the tube guide to facilitate retrograde intubation: a prospective, randomised trial. Indian J Anaesth 2011; 55: 499.
13. Dey S, Ninu M, Yunus M, Syiemiong N. Fiberoptic Guided Retrograde Intubation in an Anticipated Difficult Airway: Revival of an Antiquated Technique. J Clin Diagn Res 2016; 10: UD06-UD07.
14. Lechman MJ, Donahoo JS. Endotracheal intubation using percutaneous retrograde guidewire insertion followed by antegrade fiberoptic bronchoscopy. Crit Care Med 1986; 14: 589-90.
15. Bissinger U, Guggenberger H, Lenz G. Retrograde-guided fiberoptic intubation in patients with laryngeal carcinoma. Anesth Analg 1995; 81: 408-10.
16. Audenaert SM, Montgomery CL, Stone B, Akins RE, Lock RL. Retrograde-assisted fiberoptic tracheal intubation in children with difficult airways. Anesth Analg 1991; 73: 660-4.
17. Gupta B, McDonald JS, Brooks JH, Mendenhall J. Oral fiberoptic intubation over a retrograde guidewire. Anesth Analg 1989; 68: 517-9.
18. Rosenblatt WH, Angood PB, Maranets I, Kaklamanos IG, Garwood S. Retrograde fiberoptic intubation. Anesth Analg 1997; 84: 1142-4.
2. Dhara SS. Retrograde tracheal intubation. Anaesthesia 2009; 64: 1094-104.
3. Sawardekar A, Jagannathan N, Patel PK, Nadkarni A. Retrograde fiberoptic technique to avoid tracheostomy in a patient with a tracheocutaneous fistula and Treacher Collins syndrome. J Craniofac Surg 2011; 22: 255-6.
4. Butler FS, Cirillo A. Retrograde tracheal intubation. Anesth Analg 1960; 39: 333-8.
5. Barriot P, Riou B. Retrograde technique for tracheal intubation in trauma patients. Critical care medicine 1988; 16: 712-3.
6. Bhola N, Jadhav A, Borle R, Khemka G, ali Ajani A. Awake endotracheal retrograde intubation in restricted mouth opening: a ‘J’-tipped guide wire technique—a retrospective study. Oral Maxillofac Surg 2014; 18: 393-6.
7. Sanguanwit P, Trainarongsakul T, Kaewsawang N, Sawanyawisuth K, Sitthichanbuncha Y. Is retrograde intubation more successful than direct laryngoscopic technique in difficult endotracheal intubation? Am J Emerg Med 2016; 34: 2384-7.
8. Apfelbaum JL, Hagberg CA, Caplan RA, et al. Practice guidelines for management of the difficult airwayan updated report by the American Society of Anesthesiologists task force on management of the difficult airway. Anesthesiology 2013; 118: 251-70.
9. Wijesinghe HS, Gough JE. Complications of a retrograde intubation in a trauma patient. Academic Emerg Med 2000; 7: 1267-71.
10. Bowes WA, Johnson JO. Pneumomediastinum after planned retrograde fiberoptic intubation. Anesth Analg 1994; 78: 795-7.
11. Gill M, Madden MJ, Green SM. Retrograde endotracheal intubation: an investigation of indications, complications, and patient outcomes. Am J Emerg Med 2005; 23: 123-6.
12. Jain G, Singh DK, Yadav G, Gupta SK, Tharwani S. A modification in the tube guide to facilitate retrograde intubation: a prospective, randomised trial. Indian J Anaesth 2011; 55: 499.
13. Dey S, Ninu M, Yunus M, Syiemiong N. Fiberoptic Guided Retrograde Intubation in an Anticipated Difficult Airway: Revival of an Antiquated Technique. J Clin Diagn Res 2016; 10: UD06-UD07.
14. Lechman MJ, Donahoo JS. Endotracheal intubation using percutaneous retrograde guidewire insertion followed by antegrade fiberoptic bronchoscopy. Crit Care Med 1986; 14: 589-90.
15. Bissinger U, Guggenberger H, Lenz G. Retrograde-guided fiberoptic intubation in patients with laryngeal carcinoma. Anesth Analg 1995; 81: 408-10.
16. Audenaert SM, Montgomery CL, Stone B, Akins RE, Lock RL. Retrograde-assisted fiberoptic tracheal intubation in children with difficult airways. Anesth Analg 1991; 73: 660-4.
17. Gupta B, McDonald JS, Brooks JH, Mendenhall J. Oral fiberoptic intubation over a retrograde guidewire. Anesth Analg 1989; 68: 517-9.
18. Rosenblatt WH, Angood PB, Maranets I, Kaklamanos IG, Garwood S. Retrograde fiberoptic intubation. Anesth Analg 1997; 84: 1142-4.
| Files | ||
| Issue | Vol 6, No 2 (Spring 2019) | |
| Section | Technical Note | |
| DOI | https://doi.org/10.18502/jcr.v6i2.2267 | |
| Keywords | ||
| Fiberscope; Modified retrograde intubation; Direct visualization. | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Babakhani B, Moharrami M, Abbasi A. Retrograde fiberoptic intubation. J Craniomaxillofac Res. 2019;6(2):80-84.
