Videolaringoscopío vs FibroBroncoscopío ¿Cuál es el santo grial de la intubación del paciente con obesidad? y ¿Que dice la evidencia actual?
CRITICAL CARE & EMERGENGY MEDICINE VOL. 3
Video laryngoscope vs Fibrobronchoscope What is the holy grail of intubation of patients with obesity? And what does the current evidence say?
- 9 diciembre, 2024
- Revisión narrativa, Volumen 3.
José Ricardo Solórzano Beltrán 1, Natasha Mey Ruiz 1, Santiago Andrés Berrón Pérez 1, Irlanda Guerrero Barajas 1, Juan Carlos Flores Carrillo 2 , Manuel Alberto Guerrero Gutiérrez 3
.
1 Fellow en Alta Especialidad en Anestesiología Bariátrica. Tijuana, México.
2 Jefe de la Unidad de Terapia Intensiva de New City Hospital. Tijuana, México
3 Departamento de Anestesiología Bariátrica, Centro Médico Bariátrico. Tijuana, México.
Abstract
The rising prevalence of overweight and obesity in the adult population has made it essential for anesthesiologists to be familiar with the specific challenges these patients present, particularly in airway management. It is crucial for anesthesiologists to have knowledge of the most appropriate intubation tools and methods, supported by the literature, to address the unique needs of this patient group effectively.
Resumen
El aumento en la prevalencia de sobrepeso y obesidad en la población adulta ha generado la necesidad de que los anestesiólogos se familiaricen con los desafíos específicos que presentan estos pacientes, especialmente en el manejo de la vía aérea. Es fundamental que el anestesiólogo conozca los instrumentos y métodos de intubación más adecuados, respaldados por la literatura, para abordar de manera efectiva las particularidades de este grupo de pacientes.
Keywords
Videolaryngoscope, Flexible Fiberscope, Obesity, Difficult intubation, Difficult airway.
Biografias de autores
José Ricardo Solórzano Beltrán
Fellow en Alta Especialidad en Anestesiología Bariátrica. Tijuana, México.
Natasha Mey Ruiz
Fellow en Alta Especialidad en Anestesiología Bariátrica. Tijuana, México.
Santiago Andrés Berrón Pérez
Fellow en Alta Especialidad en Anestesiología Bariátrica. Tijuana, México.
Irlanda Guerrero Barajas
Fellow en Alta Especialidad en Anestesiología Bariátrica. Tijuana, México.
Juan Carlos Flores Carrillo
Jefe de la Unidad de Terapia Intensiva de New City Hospital. Tijuana, México
Manuel Alberto Guerrero Gutiérrez
.
Departamento de Anestesiología Bariátrica, Centro Médico Bariátrico. Tijuana, México.
Referencias
- Campos-Nonato I, Galván-Valencia O, Hernández-Barrera L, Oviedo-Solís C, Barquera S. Prevalencia de obesidad y factores de riesgo asociados en adultos mexicanos: resultados de la Ensanut 2022. Salud Publica Mex. 2023;65(supl 1):S238-S247.
- World Health Organization. Fact sheet – Obesity and overweight. Ginebra:WHO, 2024 . Disponible en: https://www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight
- Angrisani, L., Santonicola, A., Iovino, P., Palma, R., Kow, L., Prager, G., Ramos, A., Shikora, S., Fiolo, F., Harraca, J. L., Hamdorf, J., Langer, F., Beckerhinn, P., Omerov, T., Dillemans, B., Rodriguez, E. H. B., Viegas, F., Grozdev, K., Anvari, M., . . . Cordova, L. R. L. (2024). IFSO Worldwide Survey 2020–2021: CurrentTrends for Bariatric and Metabolic Procedures. Obesity Surgery, 34(4), 1075-1085. https://doi.org/10.1007/s11695-024-07118-3
- Thota B, Jan KM, Oh MW, Moon TS. Airway management in patients with obesity. Saudi J Anaesth. 2022 Jan-Mar;16(1):76-81. doi:10.4103/sja.sja_351_21
- Esquide J, Ramón de Luis, Valero César. Anestesia en la cirugía bariática. Cir Esp 2004; 75: 273-279.
- Recent advances in anesthesia of the obese patient. Faculty Rev. 2018; 7: p. 1-5.
- Apfelbaum, J. L., Hagberg, C. A., Connis, R. T., Abdelmalak, B. B., Agarkar, M., Dutton, R. P., Fiadjoe, J. E., Greif, R., Klock, P. A., Mercier, D., Myatra, S. N., O’Sullivan, E. P., Rosenblatt, W.H., Sorbello, M., & Tung, A. (2021). 2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway. Anesthesiology, 136(1), 31-81. https://doi.org/10.1097/aln.0000000000004002
- Brodsky JB, Lemmens HJ, Brock-Utne JG, Vierra M, Said- man LJ. Morbid obesity and tracheal intubation. Anesth Analg. 2002;94(3):732–6.
- Juvin P, Lavaut E, Dupont H, Lefevre P, Demetriou M, Dumoulin JL, Desmonts JM. Difficult tracheal intubation is more common in obese than in lean patients. Anesth Analg. 2003; 97(2):595–600.
- Gonzalez H, Minville V, Delanoue K, Mazerolles M, Concina D, Fourcade O. The importance of increased neck circumfer- ence to intubation difficulties in obese patients. Anesth Analg. 2008;106(4):1132–6.
- Ahmad, I., El-Boghdadly, K., Bhagrath, R., Hodzovic, I., McNarry, A. F., Mir, F., O’Sullivan, E. P., Patel, A., Stacey, M., & Vaughan, D. (2019). Difficult Airway Society guidelines for awake tracheal intubation (ATI) in adults. Anaesthesia, 75(4), 509-528. https://doi.org/10.1111/anae.14904
- Lundstrom LH, Moller AM, J.High body mass index is a weak predictor for difficult and failed tracheal intubation: a cohort study of 91,332 consecutive patients scheduled for direct laryngoscopy registered in the Danish Anesthesia Database. Anesthesiology. 2009;110(2):266–274.
- Riad W,Vaez MN,etal.Neck circumference as a predictor of difficult intubation and difficult mask ventilation in morbidly obese patients: a prospective observational study. Eur J Anaesthesiol. 2016;33(4):244–249.
- El-Ganzouri AR, McCarthy RJ, Tuman KJ, Tanck EN, Ivankovich AD. Preoperative airway assessment: predictive value of a multivariate risk index. Anesthesia and Analgesia 1996; 82: 1197–204.
- Hoshijima, H., Denawa, Y., Tominaga, A., Nakamura, C., Shiga, T., & Nagasaka, H. (2017). Videolaryngoscope versus Macintosh laryngoscope for tracheal intubation in adults with obesity: A systematic review and meta-analysis. Journal Of Clinical Anesthesia, 44, 69-75. https://doi.org/10.1016/j.jclinane.2017.11.008
- Ruetzler K, Rivas E, Cohen B, Mosteller L, Martin A, Keebler A, Maheshwari K, Steckner K, Wang M, Praveen C, Khanna S, Makarova N, Sessler DI, Turan A. McGrath Video Laryngoscope Versus Macintosh Direct Laryngoscopy for Intubation of Morbidly Obese Patients: A Randomized Trial. Anesth Analg. 2020 Aug;131(2):586-593. doi: 10.1213/ANE.0000000000004747.PMID: 32175948.
- Thong SY, Lim Y. Video and optic laryngoscopy assisted tracheal intubation–the new era. Anaesthesia and Intensive Care 2009; 37: 219–33.
- Abdellatif AA, Ali MA. GlideScope videolaryngoscope versus flexible fiberoptic bronchoscope for awake intubation of morbidly obese patient with predicted difficult intubation. Middle East J Anaesthesiol. 2014 Feb;22(4):385-92. PMID: 25007692
- Cormack RS, Lehane J. Difficult tracheal intubation in obstetrics. Anaesthesia. 1984 Nov;39(11):1105-11. PMID: 6507827.
- Abdelmalak BB, Bernstein E, Egan C, Abdallah R, You J, Sessler DI, Doyle DJ. GlideScope® vs flexible fibreoptic scope for elective intubation in obese patients. Anaesthesia. 2011 Jul;66(7):550-5. doi: 10.1111/j.1365-2044.2011.06659.x. Epub 2011 May 13. PMID: 21564041.
- Moore, A., el-Bahrawy, A., E-Mouallem, E., Lattermann, R., Hatzakorzian, R., LiPishan, W., & Schricker, T. (2017b). Videolaryngoscopy or fibreoptic bronchoscopy for awake intubation of bariatric patients with predicted difficult airways – a randomised, controlled trial. Anaesthesia, 72(4), 538-539. https://doi.org/10.1111/anae.1385
- Gaszynski, T. (2016). Comparison of the glottic view during video-intubation in super obese patients: a series of cases. Therapeutics and Clinical Risk Management, Volume 12, 1677-1682. https://doi.org/10.2147/tcrm.s118339
- Guerrero-Gutiérrez MA, Méndez-Díaz A, Da Silva-Tavares L, López-Pérez FJ, Flores-Carrillo JC & Escarramán-Martínez D. Manejo de la vía aérea en el paciente con obesidad: parte 1; ventilación e intubación. Revista Chilena de Anestesia Vol. 53 Núm. 4 pp. 388-398|https://doi.org/10.25237/revchilanestv53n4-14
How to Cite / Como citar
Licencia
© 2025 Critical Care & Emergency Medicine by Ediciones Prado. This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0) .
The copyrights of the articles published in Critical Care & Emergency Medicine belong to Ediciones Prado. The contents of the articles that appear in the Journal are exclusively the responsibility of the authors and do not necessarily reflect the opinions of the Editorial Committee of the Journal. It is allowed to reproduce the material published in Critical Care & Emergency Medicine without prior authorization for non-commercial use.



