scholarly journals Retrograde intubation: An alternative way for the management of difficult airway

1970 ◽  
Vol 6 (4) ◽  
pp. 516-519 ◽  
Author(s):  
P Lama ◽  
BR Shrestha
Keyword(s):  
Tracheal Intubation ◽  
Fiber Optic ◽  
Guide Wire ◽  
Mouth Opening ◽  
Plate Removal ◽  
Flexible Fiber ◽  
Expert User ◽  
Retrograde Intubation ◽  
Lower Mandible ◽  
Difficult Situations

Inserting a retrograde wire into the pharynx through a cricothyroid puncture can facilitate tracheal intubation in difficult situations where either a flexible fiber-optic bronchoscope or an expert user of such a device is not available. Even in cases when fibropric can not be negotiated for the purpose,this method has been claimed to be useful to manage the airway. Some mouth opening is essential for the oral or nasal retrieval of the wire from the pharynx. Here, a case of post mandibular reconstructed wound infection required surgical debridement and plate removal from reconstructed lower mandible under general anesthesia. We retrieved the guide wire passed through a cricothyroid puncture and subsequently accomplished wire-guided oro-tracheal intubation. In the absence of a flexible fiber-optic bronchoscope, this technique is a very useful aid to intubate patients with limited mouth opening. Key words: cricothyrotomy, guide wire, retrograde endotracheal intubation (REI), surgery. doi: 10.3126/kumj.v6i4.1748     Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 516-519   

Retrograde fiberoptic intubation

2020 ◽  
Author(s):  
Babak Babakhani ◽  
Mohammad Moharrami ◽  
Amir Jalal Abbasi
Keyword(s):  
Promising Result ◽  
Clinical Investigation ◽  
Guide Wire ◽  
Mouth Opening ◽  
Technical Note ◽  
New Technique ◽  
Fiberoptic Intubation ◽  
Direct Visualization ◽  
New Approach ◽  
Retrograde Intubation

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.

scholarly journals Fluoroscope-aided retrograde placement of guide wire for tracheal intubation in patients with limited mouth opening

2005 ◽  
Vol 94 (1) ◽  
pp. 128-131 ◽  
Author(s):  
B.K. Biswas ◽  
P. Bhattacharyya ◽  
S. Joshi ◽  
U.R. Tuladhar ◽  
S. Baniwal
Keyword(s):  
Tracheal Intubation ◽  
Guide Wire ◽  
Mouth Opening ◽  
Limited Mouth Opening

Awake endotracheal retrograde intubation in restricted mouth opening: a ‘J’-tipped guide wire technique—a retrospective study

2013 ◽  
Vol 18 (4) ◽  
pp. 393-396 ◽  
Author(s):  
Nitin Bhola ◽  
Anendd Jadhav ◽  
Rajiv Borle ◽  
Gaurav Khemka ◽  
Abbas ali Ajani
Keyword(s):  
Retrospective Study ◽  
Guide Wire ◽  
Mouth Opening ◽  
Retrograde Intubation

Flexible Fiber-Optic Receiver with Side-Surface Interface

2014 ◽  
Vol E97.C (12) ◽  
pp. 1154-1157 ◽  
Author(s):  
Makoto TSUBOKAWA
Keyword(s):  
Fiber Optic ◽  
Side Surface ◽  
Flexible Fiber

scholarly journals Comparison of Incidence of Difficult Intubation between Obese and Nonobese Patients, and Comparison of Three Predictors of Difficult Intubation in Obese Patients

2016 ◽  
Vol 1 (2) ◽  
pp. 41-44
Author(s):  
Johann Mathew
Keyword(s):  
Tracheal Intubation ◽  
Difficult Intubation ◽  
Mouth Opening ◽  
Difficult Tracheal Intubation ◽  
Neck Circumference ◽  
Obese Patients ◽  
Chi Square ◽  
Neck Extension ◽  
Difficulty Scale ◽  
Nonobese Patients

ABSTRACT Background Anticipating a difficult airway is of prime importance to an anesthesiologist. Data available are inconclusive to say that tracheal intubation is more difficult in the obese. The deficiency occurring with individual factors can be avoided by adopting multiple airway assessment factors. In this study, we aim to compare the incidence of difficult intubation between obese and nonobese patients and compare three predictors of difficult intubation. Study design Prospective observational study. Materials and methods About 250 patients were assigned to two groups, obese and nonobese based on their body mass index. Preoperatively, neck circumference (NC), mouth opening, thyromental distance (TMD), neck extension, NC/TM ratio, Mallampati classification (MPC), and Wilson score (WS) were calculated. Difficulty of intubation was assessed using the intubation difficulty scale (IDS). All tracheal intubations were performed by anesthetists with more than 2 years of experience. Statistical analysis used Data analysis was done with the help of Statistical Package for the Social Sciences (SPSS) version 15, MedCalc version 11, and Epi data software. Qualitative data are presented with the help of frequency and percentage table, and association among various study parameters is done with chi-square test. Results The incidence of difficult intubation determined by the IDS (≥5) was more frequent in the obese group (88.6% in obese vs 11.4% in nonobese). Of the three variables, WS was found to be statistically significant (p < 0.005). Neck circumference to thyromental ratio is a new predictor for difficult tracheal intubation (DTI). But an NC/TM ratio of ≥5 gives high false positive for our population. How to cite this article Mathew J, Gvalani SK. Comparison of Incidence of Difficult Intubation between Obese and Nonobese Patients, and Comparison of Three Predictors of Difficult Intubation in Obese Patients. Res Inno in Anesth 2016;1(2):41-44.

Wearable breath monitoring based on a flexible fiber-optic humidity sensor

2021 ◽  
pp. 130794
Author(s):  
Weijia Bao ◽  
Fengyi Chen ◽  
Huailei Lai ◽  
Shen Liu ◽  
Yiping Wang
Keyword(s):  
Humidity Sensor ◽  
Fiber Optic ◽  
Flexible Fiber ◽  
Breath Monitoring

scholarly journals 0561 Differences in Nasopharyngoscopic Airway Form Between Awake and Sleep, Sitting and Recumbent Position and Techniques

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A215-A215
Author(s):  
Y Nishimura ◽  
M Hamed
Keyword(s):  
Airway Obstruction ◽  
Fiber Optic ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Recumbent Position ◽  
Drug Induced ◽  
Airway Narrowing ◽  
Flexible Fiber ◽  
Obstructive Sleep ◽  
Anterior Posterior

Abstract Introduction To examine and compare the information derived from flexible fiber-optic nasopharyngoscopy in awake mimic snoring (AMS), Müller’s Maneuver (MM) and drug-induced sleep endoscopy (DISE), to determine if AMS and MM can be used in substitution for DISE as a streamlined method. We investigated their relation with the level and pattern of obstruction detected on AMS, MM and DISE. Methods This is a retrospective study of 15 obstructive sleep apnea patients with apnea hypopnea index from 8.3 to 105.2, ages 20 to 80 were included. Each patient underwent polysomnography and thorough a physical examination, including flexible nasopharyngoscopy with AMS, MM and DISE. Airway obstruction on these endoscopic procedures were described according to airway level and pattern of obstruction. They were classified 5 different types; Uvula type: anterior-posterior vibration of the uvula, no airway obstruction; L-R velum type: lateral (the left and right directions) airway narrowing at velum level, no airway obstruction; A-P velum type: anterior-posterior total airway obstruction at velum level; Tonsillar type: total airway obstruction at pharyngeal level; Circumferential type: circumferential total airway obstruction at velum level. AMS and MM were performed with patients in sitting and in recumbent position. DISE was performed only in recumbent position. Results In review of the three procedures, the results were much different. Airway was obstructed in all cases(100%, 15 of 15)in DISE, but not all cases in AMS and MM. When tonsillar type was seen in AMS, it was also seen in MM and DISE(100%, 5 of 5). Conclusion Flexible fiber-optic nasopharyngoscopy appears to be useful for evaluating airway obstruction. It might be not suitable to use AMS and MM in substitution for DISE(except tonsillar type). Muscle tonic relaxation of the upper airway between AMS, MM and DISE might be different (DISE&gt;MM&gt;AMS, recumbent&gt;sitting). Support  

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