Guía para la secuencia de inducción e intubación rápida en el servicio de emergencias
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nov 15, 2012
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Resumen
La secuencia de intubación rápida (SIR) es un procedimiento diseñado para minimizar el tiempo necesario en el aseguramiento de la vía aérea mediante la colocación de un tubo endotraqueal en pacientes con alto riesgo de broncoaspiración, especialmente en situaciones de emergencia. Teniendo claro este panorama, es indiscutible la importancia de la educación y el entrenamiento relacionado con la secuencia de intubación rápida que debe hacerse a los médicos responsables de las salas de reanimación, los servicios de urgencias y los paramédicos responsables del manejo de campo en emergencias y desastres. Este documento es una revisión actualizada del tema, cuyo objetivo es servir de guía para todos quienes estén interesados.
Keywords
intubación, manejo de la vía aérea, intubación intratraqueal, urgencias médicas, guía de práctica clínica, Intubation, airway management, rapid sequence intubation, emergency room, practice guidelines,
References
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3. Mace SH. Challenges and advances in intubation: airway evaluation and controversies with intubation. Emerg Med Clin N Am. 2008;26:977-1000.
4. Jabre P, Galinski M, Ricard-Hibon A, Devaud ML, Ruscev M, Kulstad E, Vicaut E, Adnet F, Margenet A, Marty J, Combes X. Out-of-hospital tracheal intubation with single-use versus reusable metal laryngoscope blades: a multicenter randomized controlled trial. Ann Emerg Med. 2011;57:225-31.
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6. Benumof JL, Dagg R, Benumof R. Critical hemoglobin desaturation will occur before return to an unparalyzed state following 1 mg/kg intravenous succinylcholine. Anesthesiology 1997;87:979-82.
7. Berthoud MC, Peacock JE, Reilly CS. Effectiveness of preoxygenation in morbidly obese patients. Br J Anaesth. 1991;67:464-6.
8. Kashyap L, Yaddanapudi LN, Sandhya. Arterial desaturation during induction with and without preoxygenation: evaluation of four techniques. Anaesth Intensive Care. 1993;21:811-3.
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12. Baillard C, Fosse JP, Sebbane M, Chanques G, Vincent F, Courouble P, Cohen Y, Eledjam JJ, Adnet F, Jaber S. Noninvasive ventilation improves preoxygenation before intubation of hypoxic patients. Am J Respir Crit Care Med. 2006;174:171-7.
13. Fox EJ, Sklar GS, Hill CH, Villanueva R, King BD. Complications related to the pressure response to endotracheal intubation. Anesthesiology. 1977;47:524-5
14. Ducey JP, Deppe SA, Foley KT. A comparison of the effects of suxamethonium, atracurium and vecuronium on intracranial
haemodynamics in swine. Anaesth
Intensive Care. 1989;17:448-55.
15. Koenig KL. Rapid-sequence intubation of head trauma patients: prevention of fasciculations with pancuronium versus minidose succinylcholine. Ann Emerg Med. 1992;21:929-32.
16. Pang YL, Tseng FL, Tsai YC, Liu YC. Suxamethonium-induced hyperkalaemia in a patient with a normal potassium level before rapid-sequence intubation. Crit Care Resusc. 2006;8:213-4.
17. Maslow AD, Regan MM, Israel E, Darvish A, Mehrez M, Boughton R, Loring SH. Inhaled albuterol, but not intravenous lidocaine, protects against intubationinduced bronchoconstriction in asthma. Anesthesiology. 2000;93:1198-204.
18. Fleming B, McCollough M, Henderson SO. Myth: Atropine should be administered before succinylcholine for neonatal and pediatric intubation. Can J Emerg Med. 2005;7:114-7
19. Fastle RK, Roback MG. Pediatric rapid sequence intubation: incidence of reflex bradycardia and effects of pretreatment with atropine. Pediatr Emerg Care. 2004;20:651-5.
20. Bean A, Jones J. Atropine: re-evaluating its use during paediatric RSI. Emerg Med J. 2007;24:361-2.
21. Abou-Madi M, Keszler H, Yacoub O. A method for prevention of cardiovascular reactions to laryngoscopy and intubation. Can Anaesth Soc J. 1975;22:316-29.
22. Chraemmer-Jørgensen B, Høilund-Carlsen PF, Marving J, Christensen V. Lack of effect of intravenous lidocaine on hemodynamic responses to rapid sequence induction of general anesthesia: a double-blind controlled clinical trial. Anesth Analg. 1986;65:1037-41.
23. Laurito CE, Baughman VL, Becker GL, Polek WV, Riegler FX, VadeBoncouer TR.Effects of aerosolized and/or intravenous lidocaine on hemodynamic responses to laryngoscopy and intubation in outpatients. Anesth Analg. 1988;67:389-92.
24. Splinter WM. Intravenous lidocaine does not attenuate the haemodynamic response of children to laryngoscopy and tracheal intubation. Can J Anaesth. 1990;37:440-3.
25. Inada E, Cullen DJ, Nemeskal AR, Teplick R. Effect of labetalol or lidocaine on the hemodynamic response to intubation: a controlled randomized double-blind study. J Clin Anesth. 1989;1:207-13.
26. Miller DR, Martineau RJ, Wynands JE, Hill J. Bolus administration of esmolol for controlling the haemodynamic response to tracheal intubation: the Canadian Multicentre Trial. Can J Anaesth. 1991;38:849-58.
27. Chung KS, Sinatra RS, Halevy JD, Paige D, Silverman DG. A comparison of fentanyl, esmolol, and their combination for blunting the haemodynamic responses during rapid-sequence induction. Can J Anaesth. 1992;39:774-9.
28. Korpinen R, Saarnivaara L, Siren K, Sarna S. Modification of the haemodynamic responses to induction of anaesthesia and tracheal intubation with alfentanil, esmolol and their combination. Can J Anaesth. 1995;42:298-304.
29. Levitt MA, Dresden GM. The efficacy of esmolol versus lidocaine to attenuate the hemodynamic response to intubation in isolated head trauma patients. Acad Emerg Med. 2001;8:19-24.
30. Scheinin B, Lindgren L, Randell T, Scheinin H, Scheinin M. Dexmedetomidine attenuates sympathoadrenal responses to tracheal intubation and reduces the need for thiopentone and peroperative fentanyl. Br J Anaesth. 1992;68:126-31.
31. Yap LC, Ho RT, Jawan B, Lee JH. Effects of magnesium sulfate pretreatment on succinylcholine facilitated tracheal intubation. Acta Anaesthesiol Sin. 1994;32:45-50.
32. Fujii Y, Saitoh Y, Takahashi S, Toyooka H. Diltiazem-lidocaine combination for the attenuation of cardiovascular responses to tracheal intubation in hypertensive patients. Can J Anaesth. 1998;45:933-7.
33. Kim JT, Shim JK, Kim SH, Ryu HG, Yoon SZ, Jeon YS, Bahk JH, Kim CS. Remifentanil vs. lignocaine for attenuating the haemodynamic response during rapid sequence induction using propofol: double-blind randomised clinical trial. Anaesth Intensive Care. 2007;35:20-3.
34. Min JH, Chai HS, Kim YH, Chae YK, Choi SS, Lee A, Choi YS. Attenuation of hemodynamic responses to laryngoscopy and tracheal intubation during rapid sequence induction: remifentanil vs. lidocaine with esmolol. Minerva Anestesiol. 2010;76(3):188-92.
35. Butler J, Jackson R. Lignocaine premedication before rapid sequence induction in head injuries. Emerg Med J. 2002;19:554.
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Cómo citar
Pérez Perilla, P., Moreno Carrillo, A., & Gempeler Rueda, F. E. (2012). Guía para la secuencia de inducción e intubación rápida en el servicio de emergencias. Universitas Medica, 54(2), 175–198. https://doi.org/10.11144/Javeriana.umed54-2.gpsi
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