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Maniobra de apertura de la vía aérea con una mano en broncoscopia flexible con sedación profunda
A one-handed maneuver for opening the airway during flexible bronchoscopy under deep sedation
Pablo Rubinstein-Aguñín
, María Luisa Domenech-Alcocer, Ricardo Leiro-Riera
Corresponding author
IDCSalud Hospital General de Catalunya, Sant Cugat del Vallès, Barcelona, España
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Realizamos la FBC por sedación profunda con un neumólogo, una enfermera y una auxiliar.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Ocasionalmente se obstruye la vía aérea (mayor predisposición en obesos, SAHS, macroglosia y retrognatia).</p><p id="par0015" class="elsevierStylePara elsevierViewall">Describimos una maniobra de apertura de la vía aérea, realizada por el endoscopista, que permite avanzar el broncoscopio a nivel supraglótico mientras se abre la vía aérea: se avanza el tubo del broncoscopio con la mano izquierda, tomándolo entre el primer y segundo dedo, mientras los dedos 3.°, 4.° y 5.° levantan la barbilla por debajo del mentón, hacia atrás y hacia arriba. La mano derecha controla el cuerpo del FBC. Ocasionalmente, la maniobra es insuficiente, y un ayudante abre la vía aérea elevando la mandíbula, pero puede ser doloroso para el paciente y sacarlo del plano de sedación.</p><p id="par0020" class="elsevierStylePara elsevierViewall">El vídeo muestra la maniobra, y la visión de la glotis durante la misma.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0030" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Anexo A" "titulo" => "Material suplementario" "identificador" => "sec0010" ] ] ] ] "multimedia" => array:1 [ 0 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 7722162 "Video" => array:2 [ "mp4" => array:2 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" ] "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:1 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "American College of Chest Physicians consensus statement on the use of topical anesthesia, analgesia, and sedation during flexible bronchoscopy in adult patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.M. Wahidi" 1 => "P. Jain" 2 => "M. Jantz" 3 => "P. Lee" 4 => "B. Mackensen" 5 => "S. Barbour" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.10-3361" "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2011" "volumen" => "140" "paginaInicial" => "1342" "paginaFinal" => "1350" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22045879" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005200000008/v1_201607230338/S0300289615003117/v1_201607230338/es/main.assets" "Apartado" => array:4 [ "identificador" => "45361" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imagen clínica" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005200000008/v1_201607230338/S0300289615003117/v1_201607230338/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615003117?idApp=UINPBA00003Z" ]
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