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https://dx.doi.org/10.48713/10...
Master thesis . 2011
License: CC BY NC SA
Data sources: Datacite
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Hallazgos ecográficos de la vía aérea superior durante la intubación endotraqueal con estilete luminoso y laringoscopia directa

Authors: Franco Gruntrad, Jan Daniel; Franco Gruntorad, Germán Andrés;

Hallazgos ecográficos de la vía aérea superior durante la intubación endotraqueal con estilete luminoso y laringoscopia directa

Abstract

La ecografía es una herramienta útil en la valoración de la vía aérea. Su uso es relativamente nuevo y su utilidad dirigida hacia la confirmación de la intubación orotraqueal, con pocos estudios al respecto. El objetivo de este estudio fue describir la prevalencia de estos hallazgos, su diferencia entre los pacientes intubados con un estilete luminoso y bajo laringoscopia directa, y así establecer su utilidad para la intubación orotraqueal. Métodos Este es un estudio tipo corte transversal, con 80 pacientes adultos sin predictores de vía aérea difícil que requirieron intubación orotraqueal en el Hospital Fundación Cardioinfantil, 40 de ellos con laringoscopia directa y la otra mitad con estilete luminoso, que fueron elegidos para seguimiento ecográfico del proceso de intubación orotraqueal, y se estableció la prevalencia de los hallazgos. Resultados Se realizó una descripción ecográfica de los hallazgos anatómicos de la vía aérea. No identificamos diferencias entre los grupos en cuanto a la identificación de una imagen específica para cada instrumento de intubación. Se logró identificar en el 100% de los pacientes el tubo endotraqueal. La prevalencia de los signos de confirmación de intubación tormenta de nieve, signo de la bala y doble línea ecogénica fue de 48,8%, 86,3%, y 87,1% respectivamente. Se encontró que el tubo orotraqueal con el estilete generan un artificio ecográfico que permite guiar la posición del tubo endotraqueal, permitiendo llevar a cabo una intubación guiada por imagen ecográfica de manera exitosa. Conclusión No identificamos diferencias entre los grupos en cuanto a la identificación de una imagen específica para cada instrumento de intubación. Se identificó en el 100% de los pacientes el tubo endotraqueal dentro de la tráquea. Existen imágenes ecográficas suficientes durante el proceso de intubación orotraqueal con estilete luminoso, que permiten llevar a cabo con éxito la intubación orotraqueal guiada por ecografía en tiempo real.

Ultrasonography has become a useful tool for upper airway assesment. Its use has been directed to confirm proper endotracheal tube placement, but have not been described properly. This study was design in order to describe the prevalence of this ultrasonographic findings, and their differences between using a light stylet or a laryngoscope for this procedure. Methods. This cross sectional study enrolled 80 patients of the Fundacion Cardioinfantil Hospital without difficult airway predictors that required orotracheal intubation, 40 of them intubated by direct laryngoscopy, and the others using the light stylet. Ultrasonographic exploration of the airway was made, and intubation was followed with the ultrasound. The prevalence of this findings was stablished. Results An ultrasonographic description of the anatomic findings of the airway was done in all the patients. There was no difference between the 2 groups in stablishing a specific sign for identifying the intubation tool. The orotracheal tube was identyfied in 100% of the patients, and the prevalence for ultrasonographic signs for the confirmation of proper endotracheal tube placement was 87,1%, 86,3% and 48,8% for the double echogenic line, the bullet sign, and the snow-storm sign respectively. We found enough ultrasonographyc findings that may let us perform a successful ultrasound guided intubation in the light stylet group. Conclussion Ultrasonography is a useful tool for assessing the upper airway. There were no differences between the use of both intubation techniques related to idetification of an specific echocardiographic sign for each of the airway instruments. The orotracheal tube was identyfied in 100% of the patients. There are enough ultrasonographic findings in the stylet group for guiding succesful endotracheal tube placement.

Keywords

Airway, Hospital fundacion cardioinfantil::Investigaciones, Atención hospitalaria::Investigaciones, Diagnostico ultrasónico::Investigaciones, Ecografía, Intubación, INTUBACION INTRATRAQUEAL - INVESTIGACIONES, Ecografía::Investigaciones, Intubation, Via aérea, Ultrasonography

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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