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Endotracheal Intubation of Rabbits Using a Polypropylene Guide Catheter

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Retrograde and submental intubation.

Cyrus A Ramsey¹, Sukhdeep S Dhaliwal

¹Fairfax Oral and Maxillofacial Surgery, Fairfax, VA 22030, USA. cramsey@fairfaxoralsurgery.com

Atlas of the Oral and Maxillofacial Surgery Clinics of North America

|February 24, 2010

Summary

Retrograde and submental intubation offer alternatives for difficult airways when direct laryngoscopy fails. These techniques have specific indications and contraindications to ensure patient safety and successful endotracheal tube placement.

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Area of Science:

Anesthesiology
Critical Care Medicine
Otolaryngology

Background:

Direct laryngoscopy is the standard for endotracheal tube (ETT) placement.
Difficult airways and failed intubations necessitate alternative airway management strategies.

Purpose of the Study:

To review the indications, contraindications, and complications of retrograde and submental intubation.
To provide guidance on alternative airway management techniques.

Main Methods:

Review of existing literature on retrograde and submental intubation techniques.
Analysis of patient populations, contraindications, and potential complications.

Main Results:

Retrograde intubation is viable in diverse patient populations (adult/pediatric, awake/sedated) with specific contraindications (e.g., nonpalpable landmarks, coagulopathies).
Submental intubation provides airway access without tracheostomy morbidity but is contraindicated in prolonged ventilation or severe floor-of-mouth trauma.
Potential complications include infection, sepsis, poor wound healing, and salivary fistula.

Conclusions:

Retrograde and submental intubation are valuable adjuncts for managing difficult airways.
Careful patient selection and awareness of contraindications are crucial for successful implementation and minimizing complications.