INTUBACIÓN TRAQUEAL FALLIDA EN OBSTETRICIA:
NO MUY FRECUENTE PERO TODAVÍA
DRA. Inés Escalona
Residente de I nivel
Durante el embarazo ocurren cambios anatómicos y fisiológicos en la mujer, que incluye mamas voluminosas que impiden la expansión torácica, edema en piel y mucosa, sobrepeso, hay un consumo metabólico de oxígeno aumentado, hiperventilación; y un volumen residual, capacidad funcional residual y volumen reserva espiratorio disminuido, que conllevan a un estado de hipercapnia e hipoxia. Esto hace que la incidencia de intubación fallida en la embarazada es 8 veces mayor que en las mujeres no gestantes, y es una causa de muertes en gestantes sometidas a anestesia general. Métodos: es un estudio realizado es la región de Tames, suroeste de Reino Unido, a partir de
Failed tracheal intubation in obstetrics: no more frequent
but still managed badly
K. Rahman(1) and J. G. Jenkins (2)
1 Specialist Registrar and 2 Consultant, Department of Anaesthesia, Royal Surrey County Hospital, Egerton Road,
Guildford, GU2 7XX, UK
Anaesthesia, 2005, 60, pages 168–171
In the South-West Thames region of the United Kingdom, during a 5-year period from 1999 to 2003, there were 20 failed tracheal intubations occurring in 4768 obstetric general anaesthetics (incidence 1 : 238). In half of the 16 cases for which the patient’s notes could be examined there was a failure to follow an accepted protocol for failed tracheal intubation.
The incidence of failed tracheal intubation in the pregnant population is perhaps eight times higher than in the non-pregnant population  and cases are usually
unexpected. The Confidential Enquiries into Maternal Deaths in the
intubation. There have been a few reports, from teaching hospitals, detailing experiences of failed intubation in obstetric anaesthesia [1, 5–7], and we have previously presented data on failed tracheal intubation in the South-West Thames region for the period 1993–98 . Here we present data on the incidence and management of failed tracheal intubation for the subsequent 5-year period, 1999–2003. South-West Thames is a relatively affluent region of the United Kingdom, which stretches from south-west London to the south coast of England; it has a mainly urban population of over 3 million and there are approximately 37 000 deliveries each year.
The results of this survey give an overall 5-year incidence of failed tracheal intubation in obstetrics of 1 : 238. This is not significantly different from the incidence of 1 :