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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El uso de <span class="elsevierStyleItalic">t&#233;cnicas fibroendosc&#243;picas ha supuesto un gran</span> avance en el manejo de las &#8220;intubaciones dif&#237;ciles&#8221;&#46; Este trabajo presenta la experiencia de un servicio hospitalario en la intubaci&#243;n guiada por broncofibroscopia &#40;BF&#41; y describe la t&#233;cnica utilizada&#46; Hemos estudiado 512 intubaciones consecutivas realizadas en los &#250;ltimos 18 a&#241;os&#46; Un 64&#44;18&#37; fueron varones y el 35&#44;15&#37; mujeres&#46; La causa m&#225;s frecuente que hizo necesaria la intubaci&#243;n mediante BF fue la patolog&#237;a no tumoral de la columna cervical &#40;28&#44;91&#37;&#41; seguida de los traumatismos &#40;18&#44;16&#37;&#41; y de la imposibilidad t&#233;cnica para intubar por medios habituales &#40;17&#44;39&#37;&#41;&#46; La v&#237;a nasal fue la m&#225;s utilizada &#40;80&#44;86&#37;&#41;&#46; El 93&#44;16&#37; de las intubaciones se realizaron por motivos quir&#250;rgicos&#46; Se registraron 35 complicaciones &#40;6&#44;84&#37;&#41; de diversa &#237;ndole y en 3 casos &#40;0&#44;59&#37;&#41; fue imposible llevar a cabo la intubaci&#243;n&#46; La intubaci&#243;n en pacientes bajo anestesia general presenta especiales dificultades t&#233;cnicas por la p&#233;rdida del tono muscular y la necesidad de mantener una ventilaci&#243;n adecuada&#46; Recomendamos realizar la intubaci&#243;n con los enfermos respirando espont&#225;neamente&#44; por v&#237;a nasal&#44; utilizando lidoca&#237;na como anest&#233;sico local y con tubos intratraqueales del mayor calibre y con el menor &#225;ngulo de bisel posible&#46;</p></span>"
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Vol. 32. Issue 8.
Pages 379-383 (October 1996)
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Vol. 32. Issue 8.
Pages 379-383 (October 1996)
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Intubación traqueal mediante broncofibroscopia (experiencia de un servicio hospitalario)
Intubation tracheal guided by fiberoptic bronchoscope: one hospital service's experience
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F. Cámara Angulo*,1, S. Domínguez Reboiras**, S. Martín Burcio*, A. Pacheco Galván**
* Servicio de Anestesiología y Reanimación. Centro Especial de la Seguridad Social. Hospital Ramón y Cajal. Madrid
** Servicio de Neumología. Centro Especial de la Seguridad Social. Hospital Ramón y Cajal. Madrid
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El uso de técnicas fibroendoscópicas ha supuesto un gran avance en el manejo de las “intubaciones difíciles”. Este trabajo presenta la experiencia de un servicio hospitalario en la intubación guiada por broncofibroscopia (BF) y describe la técnica utilizada. Hemos estudiado 512 intubaciones consecutivas realizadas en los últimos 18 años. Un 64,18% fueron varones y el 35,15% mujeres. La causa más frecuente que hizo necesaria la intubación mediante BF fue la patología no tumoral de la columna cervical (28,91%) seguida de los traumatismos (18,16%) y de la imposibilidad técnica para intubar por medios habituales (17,39%). La vía nasal fue la más utilizada (80,86%). El 93,16% de las intubaciones se realizaron por motivos quirúrgicos. Se registraron 35 complicaciones (6,84%) de diversa índole y en 3 casos (0,59%) fue imposible llevar a cabo la intubación. La intubación en pacientes bajo anestesia general presenta especiales dificultades técnicas por la pérdida del tono muscular y la necesidad de mantener una ventilación adecuada. Recomendamos realizar la intubación con los enfermos respirando espontáneamente, por vía nasal, utilizando lidocaína como anestésico local y con tubos intratraqueales del mayor calibre y con el menor ángulo de bisel posible.

Palabras clave:
Intubación traqueal
Broncofibroscopia
Técnica anestésica

Fiberoptic endoscopy has brought about significant progress in the management of so-called difficult intubations. We describe the techniques applied and results in one hospital service performing intubation guided by fiberoptic bronchoscope (FB). A total of 512 consecutive intubations (64.18% men and 35.15% women) performed over the past 18 years were analyzed. Non-tumor related disease of the cervical column (28.91%) was the most frequent cause of difficult intubation requiring FB guidance, followed by trauma (18.16%) and technical difficulties (17.39%). A nasal route was used most often (80.86%). In 93.16% of cases, intubation was needed for surgery. Thirty-five (6.84%) complications of various types were recorded, and intubation was impossible in 3 (0.59%) cases. Intubation in patients under general anesthesia presented special technical difficulties due to loss of muscle tone and the need to maintain ventilation. We recommend intubation only in patients who are breathing spontaneously through the nose, using lidocaine as a local anesthetic and a large caliber endotracheal tube with as small a tip as possible.

Key words:
Tracheal intubation
Fiberoptic bronchoscopy
Anesthetic technique
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Copyright © 1996. Sociedad Española de Neumología y Cirugía Torácica
Archivos de Bronconeumología
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