What is retrograde intubation?

From the Research

Definition and Purpose of Retrograde Intubation

Retrograde intubation is a technique used to manage difficult airways, providing an alternative to conventional intubation methods 1, 2, 3, 4, 5. This approach involves inserting a guidewire or introducer through the cricothyroid membrane or trachea and guiding an endotracheal tube over it into the trachea.

Key Characteristics and Advantages

• Can be used in emergency situations where conventional intubation fails 1, 2, 5
• Less invasive than surgical cricothyrotomy 2, 4
• Relatively easy and safe to perform 3
• Can be used in cases with supraglottic and subglottic narrowing or mass lesions 2
• May be combined with other difficult airway techniques 2

Technical Performance and Indications

• Involves percutaneous insertion of a needle into the trachea, passing a guidewire through the needle, and threading an endotracheal tube over the guidewire 3
• Indicated for expected or unexpected difficult intubation, especially when other alternative devices are not available or feasible 4
• May be used in situations with bleeding, secretions, or anatomical pathological conditions that make other intubation methods challenging 4

Risks and Pitfalls

• Although the technique is considered less invasive, it still carries risks and pitfalls, such as injury to the patient due to hypoxia, trauma of the airways, or surgical emergency procedures 4
• Requires proper training and equipment to perform safely and effectively 1, 4