A Case Report of Retrograde Intubation: An Alternative for Difficult Airway
Madhumitha Vijayaraghavan, Sam B Sheba
Keywords :
Airway management, Case report, Intubation, Nasopharyngeal carcinoma, Retrograde
Citation Information :
Vijayaraghavan M, Sheba SB. A Case Report of Retrograde Intubation: An Alternative for Difficult Airway. Res Inno Anesth 2024; 9 (1):21-23.
Retrograde intubation (RI) can be successfully used in awake, sedated, obtunded, or apneic patients who have either an anticipated or unanticipated difficult airway. The American Society of Anesthesiologists (ASA) describes RI as an alternative approach to difficult intubation in the nonemergent pathway as per their difficulty airway algorithm. It is also used as an alternative when fiberoptic scope is not available. We discussed a case of nasopharyngeal carcinoma with a difficult airway, who developed fibrosis of neck soft tissue postradiotherapy. We managed to do the RI and found it to be an effective and safe alternative in the management of a nonemergent, difficult airway.
Brambrink AM, Hagberg CA. The ASA difficult airway algorithm. Benumof and Hagberg's Airway Management. Elsevier; 2013. pp. 222–239.e2.
Gill M, Madden MJ, Green SM. Retrograde endotracheal intubation: an investigation of indications, complications, and patient outcomes. Am J Emerg Med 2005;23(2):123–126. DOI: 10.1016/j.ajem.2004.03.002
Miller RD, Eriksson LI, Fleisher LA, et al. Miller's Anesthesia. Elsevier Health Sciences; 2014.
WATERS DJ. Guided blind endotracheal intubation. For patients with deformities of the upper airway. Anaesthesia 1963;18:158–162. DOI: 10.1111/j.1365-2044.1963.tb13529.x
Stern Y, Spitzer T. Retrograde intubation of the trachea. J Laryngol Otol 1991;105(9):746–747. DOI: 10.1017/s0022215100117190
Levitan RM, Kush S, Hollander JE. Devices for difficult airway management in academic emergency departments: results of a national survey. Ann Emerg Med 1999;33(6):694–698. PMID: 10339685.
Morton T, Brady S, Clancy M. Difficult airway equipment in English emergency departments. Anaesthesia 2000;55(5):485–488. DOI: 10.1046/j.1365-2044.2000.01362.x
Contrucci RB, Gottlieb JS. A complication of retrograde endotracheal intubation. Ear Nose Throat J 1990;69(11):776–778. PMID: 2276358.
Normand KC, Aucoin AP. Retrograde intubation. The Difficult Airway. Oxford University Press; 2013. pp. 109–116.
