scholarly journals Performance of Size 1 I-Gel Compared with Size 1 ProSeal Laryngeal Mask in Anesthetized Infants and Neonates

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Gulay Erdogan Kayhan ◽  
Zekine Begec ◽  
Mukadder Sanli ◽  
Ender Gedik ◽  
Mahmut Durmus
Keyword(s):  
Primary Outcome ◽  
Good Alternative ◽  
Airway Device ◽  
Insertion Time ◽  
Supraglottic Airway ◽  
Controlled Study ◽  
Leak Pressure ◽  
Supraglottic Airway Device ◽  
Secondary Outcomes

Purpose. The size 1 I-gel, recommended for small infants and neonates weighing 2–5 kg, has recently been released. There are no prospective studies available that assess the insertion conditions, sealing pressures, or ventilation quality of it. This study was designed to compare the performance of recently released size 1 I-gel with size 1 ProSeal LMA.Methods. Fifty infants and neonates, ASA I-II were included in this prospective, randomized, and controlled study. Patients were divided into two groups for placing I-gel or ProSeal LMA. The primary outcome was airway leak pressure, and secondary outcomes included insertion time, insertion success and conditions, initial airway quality, fiberoptic view of the larynx, and complications.Results. There were no significant differences in terms of airway leak pressure between the I-gel (27.44±5.67) and ProSeal LMA (23.52±8.15) (P=0.054). The insertion time for the I-gel was shorter (12.6±2.19 s) than for the ProSeal LMA (24.2±6.059 s) (P=0.0001). Insertion success and conditions were similar in groups. We encountered few complications.Conclusion. Our study demonstrates that the size 1 I-gel provided an effective and satisfactory airway as the size 1 ProSeal LMA. It may be a good alternative supraglottic airway device for use in small infants and neonates. This trial is registered with: ClinicalTrials.govNCT01704118.

Effect of Early Supraglottic Airway Device Insertion on Chest Compression Fraction during Simulated Out-of-Hospital Cardiac Arrest: Randomized Controlled Trial

2021 ◽  
Author(s):  
Loric Stuby ◽  
Laurent Jampen ◽  
Julien Sierro ◽  
Maxime Bergeron ◽  
Erik Paus ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Controlled Trial ◽  
Face Mask ◽  
Airway Device ◽  
Supraglottic Airway ◽  
Chest Compressions ◽  
Randomized Controlled ◽  
The Difference ◽  
Hospital Cardiac Arrest

Abstract Early insertion of a supraglottic airway (SGA) device could improve CCF by allowing providers to perform continuous chest compressions or by shortening the interruptions needed to deliver ventilations. SGA devices do not require the same expertise as endotracheal intubation. This study aimed to determine whether the immediate insertion of an i-gel® while providing continuous chest compressions with asynchronous ventilations could generate higher CCFs than the standard 30:2 approach using a face-mask in a simulation of OHCA. A multicenter, parallel, randomised, superiority, simulation study was carried out. The primary outcome was the difference in CCF during the first two minutes of resuscitation. Overall and per-cycle CCF, quality of compressions and ventilations parameters were also compared. Among 13 teams of two participants, the early insertion of an i-gel® resulted in higher CCFs during the first two minutes (89.0% vs 83.6%, p=0.001). Overall and per-cycle CCF were consistently higher in the i-gel® group, even after the 30:2 alternation had been resumed. In this group, ventilation parameters were enhanced, but compressions were significantly shallower (4.6 cm vs 5.2 cm, p=0.007). This latter issue must be addressed before clinical trials can be considered.Trial registration: NCT04736446 (03/02/2021)

scholarly journals Predictors and Clinical Outcomes from Failed Laryngeal Mask Airway Unique™

2012 ◽  
Vol 116 (6) ◽  
pp. 1217-1226 ◽  
Author(s):  
Satya Krishna Ramachandran ◽  
Michael R. Mathis ◽  
Kevin K. Tremper ◽  
Amy M. Shanks ◽  
Sachin Kheterpal
Keyword(s):  
Laryngeal Mask Airway ◽  
Primary Outcome ◽  
Hospital Admissions ◽  
Airway Device ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Mask Ventilation ◽  
Supraglottic Airway Device ◽  
Respiratory Events ◽  
Unplanned Hospital Admissions

Background Although the estimated risk of life-threatening adverse respiratory events during supraglottic airway device use is rare, the reported rate of events leading to failure of the airway device is 0.2-8%. Little is known about the risk-adjusted prediction of Laryngeal Mask Airway failure requiring rescue tracheal intubation and its impact on patient outcomes. Methods All adult patients in whom a laryngeal mask airway (LMA Unique™, uLMA™; LMA North America, Inc., San Diego, CA) was used in ambulatory and nonambulatory anesthesia settings were included. The primary outcome was uLMA™ failure, defined as an airway event requiring uLMA™ removal and tracheal intubation. The secondary outcomes were the incidence of difficult mask ventilation and unplanned hospital admissions. Results Of the 15,795 cases included in our study, 170 (1.1%) experienced the primary outcome of uLMA™ failure. More than 60% of patients with uLMA™ failure experienced significant hypoxia, hypercapnia, or airway obstruction, whereas 42% presented with inadequate ventilation related to leak. Four independent risk factors for failed uLMA™ were identified: surgical table rotation, male sex, poor dentition, and increased body mass index. A 3-fold increased incidence of difficult mask ventilation was observed in patients with uLMA™ failure. Among outpatients with uLMA™ failure, 13.7% had unplanned hospital admission, 5.6% of whom needed intensive care for persistent hypoxemia. Conclusions The study supports the use of the uLMA™ as an effective supraglottic airway device with a relatively low failure rate. However, there are clinically relevant consequences of uLMA™ failure, as evidenced by the high rate of acute respiratory events and need for unplanned hospital admissions.

scholarly journals Comparison of the Disposable Streamlined Liner of the Pharynx Airway and the Disposable I-gel in Anaesthetized, Paralyzed Adults: A Randomized Prospective Study

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Khaled EL-Radaideh ◽  
Ala"a Alhowary ◽  
Diab Bani Hani
Keyword(s):  
Airway Device ◽  
Insertion Time ◽  
Supraglottic Airway ◽  
Supraglottic Airway Device ◽  
Hemodynamic Stability ◽  
Arterial Blood ◽  
Single Use ◽  
Sealing Pressure ◽  
End Tidal ◽  
Single Blind

Introduction. This study compared streamlined liner of the pharynx airway (SLIPA) and I-gel noninflatable, single-use, supraglottic airway device (SAD) performance in anesthetized, paralyzed adults.Methods. Eighty adults (ASA physical statuses I–III) who were undergoing elective procedures under general anesthesia with an SAD were enrolled in this prospective, randomized, single-blind study. Subjects were randomly and evenly assigned to the SLIPA or I-gel group for intraoperative airway management. Ease and number of insertions, insertion time, oropharyngeal sealing pressure, hemodynamic response, oxygen saturation (SpO2), end-tidal CO2(EtCO2), and peri- and postoperative complications were examined.Results. The SLIPA and I-gel devices were successfully inserted in 100% and 95% of subjects, respectively. In two I-gel subjects (5%), ventilation was not possible after two attempts, but a size 55 SLIPA was successfully inserted in both cases. Forty-two and 38 patients were ultimately included in the SLIPA and I-gel groups, respectively. Insertion time was significantly shorter with the SLIPA (11.19±3.03 s) than with the I-gel (15.05±6.37 s,P=0.003). Oropharyngeal sealing pressure was significantly higher in SLIPA (28.76±3.11 cmH2O) than in I-gel (25.9±3.65 cmH2O) subjects (P=0.001). Blood staining occurred more frequently in SLIPA (n=8, 19.0%) than in I-gel (n=5, 13.2%) patients (P<0.01). Heart rate, mean arterial blood pressure, SpO2, and EtCO2were not significantly different between groups.Conclusion. Although blood staining incidence was higher, SLIPA insertion was easier and faster than I-gel insertion. The SLIPA provided better airway sealing pressure. Both devices had similar mechanical ventilation and oxygenation characteristics and comparable hemodynamic stability. Both noninflatable SADs are useful, but SLIPA rapid insertion and good airway sealing make it an effective alternative to the I-gel.

scholarly journals Blind Intubation through Self-pressurized, Disposable Supraglottic Airway Laryngeal Intubation Masks

2017 ◽  
Vol 127 (2) ◽  
pp. 307-316 ◽  
Author(s):  
Kurt Ruetzler ◽  
Sandra Esther Guzzella ◽  
David Werner Tscholl ◽  
Tanja Restin ◽  
Marco Cribari ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Muscle Relaxation ◽  
Intensive Therapy ◽  
Airway Device ◽  
University Hospital ◽  
Supraglottic Airway ◽  
Leak Pressure ◽  
Supraglottic Airway Device ◽  
Air Leak ◽  
Supraglottic Airway Devices

Abstract Background Supraglottic airway devices commonly are used for securing the airway during general anesthesia. Occasionally, intubation with an endotracheal tube through a supraglottic airway is indicated. Reported success rates for blind intubation range from 15 to 97%. The authors thus investigated as their primary outcome the fraction of patients who could be intubated blindly with an Air-Qsp supraglottic airway device (Mercury Medical, USA). Second, the authors investigated the influence of muscle relaxation on air leakage pressure, predictors for failed blind intubation, and associated complications of using the supraglottic airway device. Methods The authors enrolled 1,000 adults having elective surgery with endotracheal intubation. After routine induction of general anesthesia, a supraglottic airway device was inserted and patients were ventilated intermittently. Air leak pressure was measured before and after full muscle relaxation. Up to two blind intubation attempts were performed. Results The supraglottic airway provided adequate ventilation and oxygenation in 99% of cases. Blind intubation succeeded in 78% of all patients (95% CI, 75 to 81%). However, the success rate was inconsistent among the three centers (P &lt; 0.001): 80% (95% CI, 75 to 85%) at the Institute of Anesthesia and Pain Therapy, Kantonsspital Winterthur, Winterthur, Switzerland; 41% (95% CI, 29 to 53%) at the Department of Anesthesiology and Intensive Therapy, Medical University of Lodz, Lodz, Poland; and 84% (95% CI, 80 to 88%) at the Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland. Leak pressure before relaxation correlated reasonably well with air leak pressure after relaxation. Conclusions The supraglottic airway device reliably provided a good airway and allowed blind intubation in nearly 80% of patients. It is thus a reasonable initial approach to airway control. Muscle relaxation can be used safely when unparalyzed leak pressure is adequate.

scholarly journals A comparative study on the perfomance between I-gel® and Classic laryngeal mask airway in anaesthetized spontaneously breathing patients

2021 ◽  
Vol 8 (3) ◽  
pp. 465-471
Author(s):  
Leno Ninan Jacob ◽  
Jaimy Mathew
Keyword(s):  
Laryngeal Mask Airway ◽  
Perioperative Complications ◽  
Airway Device ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Leak Pressure ◽  
Supraglottic Airway Device ◽  
Hemodynamic Changes ◽  
Group I ◽  
Classic Laryngeal Mask Airway

The classic Laryngeal Mask Airway (c-LMA) is a first generation supraglottic airway device with an inflatable cuff forming a low pressure seal around the laryngeal inlet and permitting ventilation. I-gel is a supraglottic airway device made of thermoplastic elastomer which is soft gel-like and transparent. Unlike the classic LMA(c-LMA), I-gel does not have an inflatable cuff. In view of this, the present study was undertaken to compare the performance of the two supraglottic airway devices in spontaneously breathing adult patients posted for elective surgeries under general anesthesia.To compare the ease of insertion, number of insertion attempts, time for insertion, airway leak pressure, hemodynamic changes as well as perioperative complications such as cough sore throat between patients using the two devices.Sixty patients admitted in SRM medical college and research center scheduled for various elective surgical procedures under general anesthesia belonging to ASA class I and II were included in the study. They were randomly divided into two groups of 30 each using a random number generator. In group I, I-gel supraglottic airway device was used and in Group 2 classic laryngeal mask airway was used. Data was collected using a questionair containing socio-demographic details, details regarding performance of the device as well as hemodynamic changes and perioperative complications.The insertion was easy in 25 patients (83.3%) in group I, while in group II 15 patients (50%) had easy insertion. P=0.0 1781. The mean time of insertion for I-gel was (20. 17± 3 .91 seconds) which was significantly shorter compared to c-LMA (26.80 ±7.24 seconds) (P&#60;0.001).There was no statistically significant difference between the devices with respect to number of attempts of insertion. Even though the airway leak pressure is not statically significant, the mean oropharyngeal leak pressure for I-gel was 20.40±5.68 (mm Hg), which was higher than c-LMA 18.73±5.06 (mm Hg), which is well within the normal limits to prevent aspiration. There were no statistically significant differences in hemodynamic changes. No Blood staining was seen after removal of device in I-gel group where it was observed in 2 (7%) patients in c- LMA group. Post removal cough was more in c -LMA (13 .3%) than l-gel (P= 0.04 SS*). Pharyngo-Laryngeal morbidity was more with classic LMA. Sore throat was more with the classic LMA (13 .3%) when compared to I-gel group (3%).We conclude that I-gel is a better airway when compared to c-LMA with respect to ease of insertion, shorter duration for insertion, adequate oropharyngeal seal with lesser pharyngo-laryngeal morbidity and less incidence of airway trauma.

Comparison of endoscopic endotracheal intubation and the v-gel supraglottic airway device for spontaneously ventilating New Zealand white rabbits undergoing ovariohysterectomy

2020 ◽  
Vol 187 (10) ◽  
pp. e84-e84
Author(s):  
Jessica Comolli ◽  
Rodney Schnellbacher ◽  
Hugues Beaufrere ◽  
Uriel Blas-Machado ◽  
Jane Quandt ◽  
...  
Keyword(s):  
New Zealand ◽  
Endotracheal Intubation ◽  
Airway Device ◽  
Supraglottic Airway ◽  
Controlled Study ◽  
Positive Pressure ◽  
Supraglottic Airway Device ◽  
Arterial Blood ◽  
Airway Trauma ◽  
New Zealand White Rabbits

BackgroundDue to the technical difficulties with endotracheal intubation of rabbits, a prospective, randomised, controlled study was performed to compare a rabbit-specific supraglottic airway device (SGAD), the v-gel, with endoscopic endotracheal intubation (EEI) in spontaneously breathing rabbits undergoing ovariohysterectomy.MethodsFourteen adult female New Zealand white rabbits were randomly allocated to one of two groups based on the method of airway establishment: EEI or v-gel SGAD. Anaesthesia was induced with ketamine and xylazine and maintained using isoflurane in 100 per cent oxygen. Comparisons were made between groups based on placement time of endotracheal tube/SGAD, number of attempts and adjustments, the necessity to increase isoflurane concentrations to maintain a surgical plane of anaesthesia, arterial blood gas values, gross laryngeal evaluation, and laryngotracheal histopathology.ResultsBoth techniques resulted in elevated arterial pCO2 levels, but the v-gel was associated with more elevated pCO2 in comparison with EEI (P=0.045). Airway trauma was histologically present but clinically negligible in both groups, with no statistically significant differences observed between techniques (P>0.05). Placement time of the v-gel was significantly faster (P=0.003) and required less technical skill than EEI, but was more easily displaced when changing the animal’s position (P=0.004).ConclusionThe v-gel is a practical alternative to EEI for securing the airway of healthy spontaneously ventilating rabbits, provided a capnograph is utilised to ensure continuous placement. Both airway techniques appear safe and effective with few complications, as long as intermittent positive pressure ventilation can be employed to correct hypercapnia.

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