Video Experimental Relacionado
Updated: May 12, 2026
11:19
Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
18.3K
Intubación de Fibra Óptica Despierta para Compresión Traqueal Severa Causada por un Bocio Multinodular: Un Informe de
Rita Leite Aguiar1, Patrícia Santos1, Amélia Ferreira1
1Anesthesiology, Centro Hospitalar e Universitário de São João, Porto, PRT.
Cureus
|January 12, 2026
Resumen
Los bocios masivos pueden obstruir las vías respiratorias, haciendo que los procedimientos estándar no sean seguros. Este caso muestra que una intubación de fibra óptica despierta (AFOI) fallida requiere reevaluación, no abandono, para un manejo exitoso de las vías respiratorias.
Sus antecedentes:
- Los bocios multinodulares masivos presentan desafíos significativos para las vías respiratorias.
- La compresión traqueal y la distorsión anatómica pueden hacer que el acceso convencional y el acceso de frente al cuello (FONA) no sean seguros.
Objetivo del estudio:
- Describir una estrategia exitosa de manejo de las vías respiratorias para un paciente con un bocio multinodular masivo y compresión traqueal severa.
- Destacar la importancia de la reevaluación después de una intubación de fibra óptica despierta (AFOI) fallida y la necesidad de un plan de extubación escalonada.
Principales métodos:
- Informe de caso de un hombre de 53 años con estrechamiento traqueal severo debido a un bocio multinodular.
- La AFOI inicial falló; la reevaluación multidisciplinaria condujo a una AFOI exitosa en el segundo intento.
- Se realizó tiroidectomía, seguida de una extubación escalonada utilizando un catéter de intercambio de vías respiratorias.
Principales resultados:
- Se logró un manejo exitoso de las vías respiratorias mediante la reevaluación y optimización de la técnica de intubación despierta.
- Una estrategia de extubación escalonada previno complicaciones postoperatorias.
- Se discute la oxigenación por membrana extracorpórea (ECMO) como rescate potencial en escenarios extremos.
Conclusiones:
- La AFOI fallida requiere reevaluación y optimización, no el abandono inmediato del enfoque despierto.
- La planificación multidisciplinaria y una estrategia de extubación escalonada son cruciales para el manejo de las vías respiratorias difíciles en pacientes con compresión traqueal severa relacionada con bocio.
- Los dispositivos de intercambio de vías respiratorias pueden facilitar una extubación segura en pacientes de alto riesgo.
Palabras clave:
manejo de la vía aéreamanejo de la vía aérea difícilcompresión traqueal severabocio subesternalcompresión traquealestenosis traquealMás Videos Relacionados
Videos de Conceptos Relacionados
01:22Trachea
The trachea, commonly known as the windpipe, is a vital part of the human respiratory system. It serves as a passageway for air to travel between the larynx and the bronchi, allowing oxygen to reach the lungs. Let's explore its anatomical features, dimensions, layers of the tracheal wall, associated muscles, and the functions of its parts.
Anatomical Features:
Location: About half of the trachea is situated in the neck, anterior to the esophagus, and extends from the larynx (at the level of the...
Anatomical Features:
Location: About half of the trachea is situated in the neck, anterior to the esophagus, and extends from the larynx (at the level of the...
01:28Tracheostomy: Procedure and Tubes
A tracheostomy is a surgical procedure that creates an artificial opening into the trachea, typically at the second or third cartilaginous ring level. This opening allows the insertion of a tracheostomy tube, which can replace an endotracheal tube, provide mechanical ventilation, bypass an upper airway obstruction, or remove accumulated tracheobronchial secretions.
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
01:15Endotracheal Intubation I: Procedure
Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
01:17Endotracheal Intubation II: Nursing Management
Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
01:30Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway interventions are...
01:27Goiter
Goiter refers to an abnormal enlargement of the thyroid gland that may appear as a diffuse goiter (uniform enlargement) or nodular (single or multiple nodules). Functionally, it is classified as nontoxic (normal/low hormone levels) or toxic (excess hormone production).PathophysiologyDiffuse thyroid enlargement typically results from prolonged stimulation by thyroid-stimulating hormone (TSH) or TSH-like agents, commonly seen in hypothyroidism or iodine deficiency. In contrast, in hyperthyroid...