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Airway Device (airway + device)

Distribution by Scientific Domains

Medical Sciences	100%

Kinds of Airway Device

new supraglottic airway device

supraglottic airway device

Selected Abstracts

Novel Airway Devices: Spoilt for Choice?

ANAESTHESIA, Issue 2 2003
T. M. Cook
First page of article [source]

Randomized comparison of the SLIPA (Streamlined Liner of the Pharynx Airway) and the SS-LM (Soft Seal Laryngeal Mask) by medical students

EMERGENCY MEDICINE AUSTRALASIA, Issue 5-6 2006
Cindy Hein
Abstract Objective:, The aim of the study was to compare the Streamlined Liner of the Pharynx Airway (SLIPA; Hudson RCI), a new supraglottic airway device, with the Soft Seal Laryngeal Mask (SS-LM; Portex) when used by novices. Methods:, Thirty-six medical students with no previous airway experience, received manikin training in the use of the SLIPA and the SS-LM. Once proficient, the students inserted each device in randomized sequence, in two separate patients in the operating theatre. Only two insertion attempts per patient were allowed. Students were assessed in terms of: device preference; success or failure; success at first attempt and time to ventilation. Results:, Sixty-seven per cent of the students preferred to use the SLIPA (95% confidence interval 49,81%). The SLIPA was successfully inserted (one or two attempts) in 94% of patients (34/36) and the SS-LM in 89% (32/36) (P = 0.39). First attempt success rates were 83% (30/36) and 67% (24/36) in the SLIPA and SS-LM, respectively (P = 0.10). Median time to ventilation was shorter with the SLIPA (40.6 s) than with the SS-LM (66.9 s) when it was the first device used (P = 0.004), but times were similar when inserting the second device (43.8 s vs 42.9 s) (P = 0.75). Conclusions:, In the present study novice users demonstrated high success rates with both devices. The SLIPA group achieved shorter times to ventilation when it was the first device they inserted, which might prove to be of clinical significance, particularly in resuscitation attempts. Although the Laryngeal Mask has gained wide recognition for use by both novice users and as a rescue airway in failed intubation, the data presented here suggest that the SLIPA might also prove useful in these areas. [source]

A new supraglottic airway device: LMA-SupremeÔ, comparison with LMA-ProsealÔ

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2009
T. HOSTEN
Background and objective: The LMA-SupremeÔ (S-LMAÔ) is a new supraglottic airway device that presents combined features of flexibility, curved structure and single use and a different cuff structure. The purpose of this study was to compare the oropharyngeal leak pressures (OLP) of LMA-ProsealÔ (P-LMAÔ) and S-LMAÔ. Methods: Sixty adult patients were prospectively and randomly allocated to undergo insertion of P-LMAÔ (n=30) or S-LMAÔ (n=30). The cuffs were inflated until the intracuff pressure (ICP) reached 60 cm H2O. Orogastric leak pressures, insertion times, first attempt success rates, fiberoptical assessment of position, cuff pressures, orogastric tube (OGT) placement and OGT insertion times were compared. Unblinded observers collected intraoperative data and blinded observers collected post-operative data. Results: The first insertion attempts and time taken to provide an effective airway were similar between the groups. Two patients (P-LMAÔ, n=1; S-LMAÔ, n=1) were intubated due to excessive oropharyngeal leak and in one patient (P-LMAÔ, n=1) due to failed OGT placement. OLPs were similar (P-LMAÔ; 26.9±6.6 S-LMAÔ; 26.1±5.2). ICP increased significantly in the P-LMAÔ at the 30 and 60 min during anesthesia (P-LMAÔ; 80.1±12.8, 92.9±14.4, S-LMAÔ; 68.3±10.9, 73.7±15.6). OGT placement was successful in all patients in the S-LMAÔ, but failed in five patients in the P-LMAÔ (P=0.02). Fiberoptically determined anatomic position was better with the P-LMAÔ (P=0.03). Conclusion: Our findings suggest that S-LMAÔ had leak pressures similar to the P-LMAÔ, and this new airway device proved to be successful during both spontaneous and positive pressure ventilation. [source]

The I-gel®, a single-use supraglottic airway device with a non-inflatable cuff and an esophageal vent: an observational study in children

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 3 2009
L. BEYLACQ
Background: The I-gel® is a new single-use supraglottic airway device with a non-inflatable cuff. It is composed of a thermoplastic elastomer and a soft gel-like cuff that adapts to the hypopharyngeal anatomy. Like the LMA-ProSeal, it has an airway tube and a gastric drain tube. Little is known about its efficiency in pediatric anesthesia. Methods: Fifty children above 30 kg, ASA I,II, undergoing a short-duration surgery were included in this prospective, observational study. We evaluated ease in inserting the I-gel®, seal pressure, gastric leak, complications during insertion and removal, ease in inserting the gastric tube and ventilatory parameters during positive pressure ventilation. Results: All devices were inserted at the first attempt. The mean seal pressure was 25 cmH2O. There was no gastric inflation and gastric tube insertion was achieved in all cases. The results appear similar to those in a previous study concerning laryngeal mask airway in terms of leak pressure and complication rates. Conclusion: Because the I-gel® has a very good insertion success rate and very few complications, it seems to be an efficient and safe device for pediatric airway management. [source]

Insertion characteristics, sealing pressure and fiberoptic positioning of CobraPLA in children

PEDIATRIC ANESTHESIA, Issue 10 2007
MAURIZIO PASSARIELLO MD
Summary Background:, The CobraPLATM is a new supraglottic airway device designed for the use in spontaneously breathing and mechanically ventilated patients. In adults it has been found as effective as the LMA, but with better sealing qualities. The aim of the present study was to evaluate fit and sealing characteristics of CobraPLA size 1.5 and 2 in mechanically ventilated children. Methods:, Forty children, ASA I/II, aged 1,10 years, weighing 10,35 kg were scheduled for minor surgical procedures. The number of attempts for insertion and fiberoptic positioning of the CobraPLA was assessed. After muscle relaxation had been achieved, airway sealing pressure was measured by gradually increasing maximum inspiratory pressure to a maximum of 30 cmH2O. Results:, Insertion of CobraPLA was successful at the first attempt in 90% of patients. The vocal cords were visualized in 90% of patients (grade 0: 2.5%, grade 1: 7.5%, grade 2: 30%, grade 3: 15%, grade 4: 45%). Median sealing pressure was 20.0 ± 6.0 cmH2O. In 21% of patients gastric insufflation was observed at a peak inspiratory pressure of 20 cmH2O or below. Conclusions:, The CobraPLA was found to have easy insertion characteristics and good anatomical fitting in children between 10 and 35 kg. If positive pressure ventilation with CobraPLA size 1.5 and 2.0 is required, peak inspiratory pressure should be kept below the leak pressure and the abdomen closely monitored for signs of gastric insufflation. [source]

The ProSealTM laryngeal mask airway in children

PEDIATRIC ANESTHESIA, Issue 3 2005
M. LOPEZ-GIL MD
Summary Background :,The ProSealTM (PLMA) is a new laryngeal mask device with a modified cuff to improve the seal and a drain tube to provide access to the gastrointestinal tract. We assessed the performance of the size 2 (which has no dorsal cuff) and size 3 (which has a dorsal cuff) in terms of insertion success, efficacy of seal, tidal volume, gas exchange, fiberoptic position, gastric tube placement and frequency of problems. Methods :,Eighty children undergoing minor surgery were studied (n = 40, size 2 PLMA, weight 10,25 kg; n = 40, size 3 PLMA, weight >25,50 kg). Induction was with remifentanil and propofol. Insertion was with the introducer tool and by experienced users. Maintenance was with propofol or sevoflurane and pressure controlled ventilation. Results :,The first-time and overall insertion success rate was 84 and 100%, respectively. Oropharyngeal leak pressure was 31 ± 5 cmH2O. There were no gastric or drain tube air leaks. Tidal volume and gas exchange was adequate in all patients, other than two brief episodes of hypoxia because of airway reflex activation. The vocal cords and epiglottis were visible in 99 and 80%, respectively, via the airway tube. The first-time and overall insertion success rate for gastric tube insertion was 87 and 100%, respectively. During maintenance, the PLMA was removed in one patient with airway reflex activation and another required epinephrine for bronchospasm. There were no differences in performance between the sizes 2 and 3 PLMA. Conclusion :,The PLMA is an effective airway device in children and isolates the glottis from the esophagus when correctly positioned. Despite the lack of a dorsal cuff, the performance of the size 2 was similar to the size 3 PLMA in the age groups tested. [source]

In vitro study of magnetic resonance imaging artefacts of six supraglottic airway devices

ANAESTHESIA, Issue 6 2010
M. Zaballos
Summary We investigated the artefacts created during magnetic resonance imaging by five different laryngeal mask airways: the Classic (cLMAÔ); the LMA ProSealÔ; the LMA UniqueÔ; the Ambu® Disposable Laryngeal Mask; the LMA SupremeÔ; and one other supraglottic airway device, the i-gel supraglottic airway. The devices were placed on top of and inside a phantom simulator to resemble the position in vivo. The artefacts with the cLMA, Unique and Supreme were similar and related to ferromagnetic material in the pilot balloon valve. Artefacts were more prominent with the ProSeal. There were no artefacts with the Ambu Disposable Laryngeal Mask or the i-gel. [source]

High frequency jet ventilation through a supraglottic airway device: a case series of patients undergoing extra-corporeal shock wave lithotripsy

ANAESTHESIA, Issue 12 2009
D. J. Canty
Summary High frequency jet ventilation has been shown to be beneficial during extra-corporeal shock wave lithotripsy as it reduces urinary calculus movement which increases lithotripsy efficiency with better utilisation of shockwave energy and less patient exposure to tissue trauma. In all reports, sub-glottic high frequency jet ventilation was delivered through a tracheal tube or a jet catheter requiring paralysis and direct laryngoscopy. In this study, a simple method using supraglottic jet ventilation through a laryngeal mask attached to a circle absorber anaesthetic breathing system is described. The technique avoids the need for dense neuromuscular blockade for laryngoscopy and the potential complications associated with sub-glottic instrumentation and sub-glottic jet ventilation. The technique was successfully employed in a series of patients undergoing lithotripsy under general anaesthesia as an outpatient procedure. [source]

Prehospital airway management on rescue helicopters in the United Kingdom

ANAESTHESIA, Issue 6 2009
M. Schmid
Summary Adequate equipment is one prerequisite for advanced, out of hospital, airway management. There are no data on current availability of airway equipment on UK rescue helicopters. An internet search revealed all UK rescue helicopters, and a questionnaire was sent to the bases asking for available airway management items. We identified 27 helicopter bases and 26 (96%) sent the questionnaire back. Twenty-four bases (92%) had at least one supraglottic airway device; 16 (62%) helicopters had material for establishing a surgical airway (e.g. a cricothyroidotomy set); 88% of the helicopters had CO2 detection; 25 (96%) helicopters carried automatic ventilators; among these, four (15%) had sophisticated ventilators and seven (27%) helicopters carried special face masks suitable for non-invasive ventilation. We found a wide variation in the advanced airway management equipment that was carried routinely on air ambulances. Current guidelines for airway management are not met by all UK air ambulances. [source]

A simple fibreoptic assisted laryngoscope for paediatric difficult intubation: a manikin study,

ANAESTHESIA, Issue 4 2009
K. Komiya
Summary The fibreoptic assisted laryngoscope is a new airway device. We compared the fibreoptic assisted laryngoscope with the Bullard laryngoscope, Macintosh laryngoscope and fibreoptic bronchoscope in a manikin with a simulated Cormack and Lehane Grade 4 laryngoscopic view. Eighteen anaesthetists intubated the manikin's trachea using these devices and the success rate of intubation was measured. They were then asked to rate the subjective difficulty of intubation. The success rate (95% confidence interval) was 100% (94.6,100) with the fibreoptic assisted laryngoscope, 88.9% (80.5,97.3) using the Bullard laryngoscope, 37.0% (24.1,49.9) with the Macintosh laryngoscope, and 22.2% (11.1,33.3) using the fibreoptic bronchoscope. Tracheal intubation using the fibreoptic assisted laryngoscope or Bullard laryngoscope is easier than that using the Macintosh laryngoscope or fibreoptic bronchoscope by subjective difficulty score. All of the intubations were successful with the fibreoptic assisted laryngoscope without practice. These results suggest that fibreoptic assisted laryngoscope may be a useful tool for paediatric difficult intubation. [source]

The Laryngeal Mask Airway SupremeTM, a single use laryngeal mask airway with an oesophageal vent.

ANAESTHESIA, Issue 1 2009
A randomised, anaesthetised patients, cross-over study with the Laryngeal Mask Airway ProSealTM in paralysed
Summary The LMA SupremeTM is a new extraglottic airway device which brings together features of the LMA ProSealTM, FastrachTM and UniqueTM. We test the hypothesis that ease of insertion, oropharyngeal leak pressure, fibreoptic position and ease of gastric tube placement differ between the LMA ProSealTM and the LMA SupremeTM in paralysed anesthetised patients. Ninety-three females aged 19,71 years were studied. Both devices were inserted into each patient in random order. Two attempts were allowed. Digital insertion was used for the first attempt and guided insertion for the second attempt. Oropharyngeal leak pressure and fibreoptic position were determined during cuff inflation from 0 to 40 ml in 10 ml increments. Gastric tube insertion was attempted if there was no gas leak from the drain tube. First attempt and overall insertion success were similar (LMA ProSealTM, 92% and 100%; LMA SupremeTM 95% and 100%). Guided insertion was always successful following failed digital insertion. Oropharyngeal leak pressure was 4,8 ml higher for the LMA ProSealTM over the inflation range (p < 0.001). Intracuff pressure was 16,35 cm higher for the LMA ProSealTM when the cuff volume was 20,40 ml (p < 0.001). There was an increase in oropharyngeal leak pressure with increasing cuff volume from 10 to 30 ml for both devices, but no change from 0 to 10 ml and 30,40 ml. There were no differences in the fibreoptic position of the airway or drain tube. The first attempt and overall insertion success for the gastric tube was similar (LMA ProSealTM 91% and 100%; LMA SupremeTM 92% and 100%). We conclude that ease of insertion, gastric tube placement and fibreoptic position are similar for the LMA ProSealTM and LMA SupremeTM in paralysed, anaesthetised females, but oropharyngeal leak pressure and intracuff pressure are higher for the LMA ProSealTM. [source]

Monitoring pollution by proton-transfer-reaction mass spectrometry during paediatric anaesthesia with positive pressure ventilation via the laryngeal mask airway or uncuffed tracheal tube

ANAESTHESIA, Issue 7 2002
J. Rieder
Summary Twenty children aged 2,66 months were randomly allocated for airway management with either the laryngeal mask airway or uncuffed tracheal tube using intermittent positive pressure ventilation with a tidal volume of 8 ml.kg,1 and a respiratory rate adjusted to maintain end-expiratory carbon dioxide concentration at 5.3 kPa. Induction was with fentanyl/propofol and maintenance was with sevoflurane 2.5% in oxygen/air. The airway device was removed when the patients were awake and the patients were transferred to the postanaesthesia care unit 10 min later. Air was sampled from a point 1.5 m above the floor at a location remote from the ventilation outlet and analysed using a proton-transfer-reaction mass spectrometer capable of continuous trace gas analysis at the parts per billion volume (ppbv) level. The concentration of sevoflurane was recorded every minute during three consecutive phases: for 5 min before the introduction of sevoflurane (background); after introduction of sevoflurane until removal of the airway device (intra-operative); and every minute after removal until the concentration returned to background levels. Median (interquartile range [range]) intra-operative sevoflurane concentrations were 200,400 times higher than background values for the laryngeal mask airway 1 (1,2 [0,3]) ppbv vs. 404 (278,523 [83,983]) ppbv, respectively, and the tracheal tube 2 (1,3 [0,5]) ppbv vs. 396 (204,589 [107,1735]) ppbv (both p <,0.0001), and returned to background values within 5 min of removal. There were no differences in sevoflurane concentration between devices intra-operatively or after removal. The performance of the proton-transfer-reaction mass spectrometer was identical at the start and end of the 30-day study. We conclude that peri-operative sevoflurane concentration in a modern operating theatre is similar for the laryngeal mask airway and the uncuffed tracheal tube in paediatric patients receiving intermittent positive pressure ventilation. Intra-operative sevoflurane concentrations are five times lower than occupational safety limit requirements, and 1000 times lower 5 min after removal of the airway device with the patient awake. The proton-transfer-reaction mass spectrometer has potential for monitoring air quality in the operating theatre. [source]

Difficult airway equipment in English emergency departments

ANAESTHESIA, Issue 5 2000
T. Morton
The need for tracheal intubation in the emergency department is often unpredictable and precipitous in nature. When compared with the operating room, a higher incidence of difficult intubation is observed. There are currently no accepted guidelines with respect to the stocking of difficult airway equipment in the emergency department. We have conducted a telephone survey to determine the availability of equipment for the management of the difficult airway in English emergency departments. Overall, the majority of units held a curved laryngoscope blade (100%), gum elastic bougie (99%) and surgical airway device (98%). Of alternative devices for ventilation, a laryngeal mask airway was kept by 65% of departments, a needle cricothyroidostomy kit by 63% and an oesophageal-tracheal twin-lumen airway (Combitube) by 18%. Of alternative devices for intubation, fewer than 10% held a retrograde intubating kit, intubating laryngeal mask, bronchoscope or lighted stylet. Seventy-four per cent of departments held an end-tidal carbon dioxide detector. [source]

Colour coding: a must for extraglottic airway devices

ANAESTHESIA, Issue 8 2010
T. C. R. V. Van Zundert
No abstract is available for this article. [source]

In vitro study of magnetic resonance imaging artefacts of six supraglottic airway devices

Evaluation of the LMA SupremeÔ in 100 non-paralysed patients,

ANAESTHESIA, Issue 5 2009
T. M. Cook
Summary We studied the LMA SupremeÔ in 100 elective, anaesthetised, healthy patients assessing: ease of use, airway quality, anatomical and functional positioning, airway leak and complications. Insertion was successful on first, second or third attempt in 90, nine and one patient respectively. Thirty manipulations were required in 22 patients to achieve a clear airway. Median [interquartile (range)] insertion time was 18 [10,25 (5,120)] s. During ventilation, an expired tidal volume of 7 ml.kg,1 was achieved in all patients. Median [interquartile (range)] airway leak pressure was 24 [20,28 (13,40)] cmH2O. On fibreoptic examination via the device, vocal cords were visible in 83 patients (85%). During maintenance, five patients (5%) required 13 airway manipulations. There was one episode of minor regurgitation, without aspiration. Other complications and patient side-effects were mild and few. The LMA Supreme is easily and rapidly inserted, providing a reliable airway and good airway seal. Further studies are indicated to assess safety and performance compared to other supraglottic airway devices. [source]

Patient safety incidents associated with airway devices in critical care: a review of reports to the UK National Patient Safety Agency

ANAESTHESIA, Issue 4 2009
A. N. Thomas
Summary We used key words and letter sequences to identify airway-associated patient safety incidents submitted to the UK National Patient Safety Agency from critical care units in England and Wales. We identified 1085 such airway incidents submitted in the two years from October 2005 to September 2007. Three hundred and twelve incidents (28.8%) involved neonates or babies. Of the total 1085 incidents, 200 (18.4%) were associated with tracheal intubation, 53 (4.9%) with tracheostomy and 893 (82.3%) were post-procedure problems. One hundred and ten incidents (10.1%) were associated with more than temporary harm. Eighty-eight intubation incidents were associated with equipment problems. Partial displacement of tubes resulted in more than temporary harm to the patient more frequently than complete tube displacement (15.7% vs 3.8%). Capnography was not described in any cases of displacement or blockage of tracheal or tracheostomy tubes. Recommendations concerning minimum standards for capnography, availability and checking of equipment and tracheostomy placement are made. [source]