A comparison of 3 ventilation strategies in children younger than 1 year using a Proseal laryngeal mask airway: a randomized controlled trial

Templeton, T. Wesley; Hoke, Lauren K.; Templeton, Leah B.; Ririe, Douglas G.; Rose, Danielle M.; Bryan, Yvon F.

doi:10.1016/j.jclinane.2016.07.042

Cited by 8 publications

(10 citation statements)

References 16 publications

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“…Sir—Multiple recent studies have confirmed the efficacy and safety of different supraglottic devices designed for use in infants and young children . At this time, there are limited, if any, data on the dead space of these devices and therefore limited consideration for the impact of device selection on ventilation in very young infants and neonates.…”

Section: Summary Of Dead Space Volume In Each Device With Standard Dementioning

confidence: 99%

An in vitro analysis of the dead space in 5 supraglottic airway devices intended for use in small children and infants

Templeton

Goenaga‐Díaz

Templeton

et al. 2018

Pediatric Anesthesia

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Section: Summary Of Dead Space Volume In Each Device With Standard Dementioning

confidence: 99%

An in vitro analysis of the dead space in 5 supraglottic airway devices intended for use in small children and infants

Templeton

Goenaga‐Díaz

Templeton

et al. 2018

Pediatric Anesthesia

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“…The primary finding of this study is that use of an air-Q ® SGA is associated with significantly more apparatus and anatomic deadspace when compared to an ETT. Further, while this difference is intuitive, the actual magnitude of weight-adjusted deadspace, especially in very young children, exceeds reasonable expectations of tidal volume during spontaneous ventilation in young children undergoing anesthesia [ 3 ]. Additionally, this deadspace will have to be compensated for when selecting mechanical ventilator settings to maintain CO 2 homeostasis calling into question the wisdom of smaller tidal volume, lung protective ventilation strategies in very young children even in some cases when an ETT is present.…”

Section: Discussionmentioning

confidence: 99%

“…Although SGAs are presumed to contribute greater deadspace volume to the ventilation circuit when compared to endotracheal tubes (ETT), there has been minimal research that quantifies that difference. This information is relevant in very young patients breathing spontaneously through these devices, who may be unable to generate sufficient tidal volumes to compensate for this added deadspace over time, and in those undergoing positive pressure ventilation who may require increasing levels of support to maintain adequate levels of ventilation [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

A comparison of the breathing apparatus deadspace associated with a supraglottic airway and endotracheal tube using volumetric capnography in young children

Goenaga‐Díaz

Smith

Pecorella

et al. 2021

Korean J Anesthesiol

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Background: Supraglottic airway (SGA) devices including the air-Q® are being used with increasing frequency for anesthesia in infants and younger pediatric patients. To date, there is minimal research documenting the potentially significant airway deadspace these devices may contribute to the ventilation circuit when compared to an endotracheal tube (ETT). The aim of this study was to evaluate the airway apparatus deadspace associated with an air-Q® versus an ETT in young children.Methods: In a prospective cohort study, 59 patients between 3 months and 6 years of age, weighing between 5 and 20 kg, scheduled for outpatient urologic or general surgery procedures were recruited. An air-Q® or ETT was inserted at the discretion of the attending anesthesiologist, and tidal volume, positive end expiratory pressure, respiratory rate, and end-tidal CO2 were controlled according to protocol. Airway deadspace was recorded using volumetric capnography every 2 min for 10 min. Results: Groups were similar in demographics. There was a significant difference in weight-adjusted deadspace volume between the air-Q® and ETT groups, 4.1 ± 0.8 ml/kg versus 3.0 ± 0.7 ml/kg, respectively (P < 0.001). Weight-adjusted deadspace volume (ml/kg) increased significantly with decreasing weight for both the air-Q® and ETT groups.Conclusions: In healthy children undergoing positive pressure ventilation for elective surgery, the air-Q® SGA introduces significantly greater airway deadspace than an ETT. Additionally, airway deadspace, and minute ventilation required to maintain normocarbia, appear to increase with decreasing patient weight irrespective of whether a SGA or ETT is used.

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“…Controlled ventilation and pressure support ventilation have been shown to be superior to spontaneous ventilation with ProSeal LMA © . [ 12 13 14 ] Spontaneous ventilation or controlled ventilation using Bain's or Jackson Rees circuit was the most commonly used method of ventilation while using SGAD amongst our respondents. This is in contrast to the SPA survey where pressure support ventilation was used by a large number of respondents.…”

Section: Discussionmentioning

confidence: 99%

Current practice patterns of supraglottic airway device usage in paediatric patients amongst anaesthesiologists: A nationwide survey

et al. 2018

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Background and Aims:Supraglottic airway devices (SGADs) are increasingly being used for airway management in paediatric patients undergoing general anaesthesia. This survey was designed to assess the nationwide practice patterns of SGAD usage in paediatric patients.Methods:A questionnaire of 28 questions was circulated amongst 16,532 members of the Indian Society of Anaesthesiologists through online survey engine Google Forms® and served manually to 500 delegates attending the Asian Society of Paediatric Anaesthesiologists conference 2017. Percentage, mean and standard deviation were calculated using Microsoft Excel 2016 (Redmond, WA, USA).Results:Four hundred and five (2.3%) valid responses were obtained. The most commonly used device was i-gel© (60.74%). Three hundred and four (75.06%) respondents had access to second-generation SGADs. Second-generation devices (60.74%) were more commonly used than first-generation devices (39.26%). Anaesthesiologists utilised SGADs in various challenging scenarios such as in the difficult airway (53.33%), remote locations (55.47%), ophthalmologic (38.77%) and long-duration surgeries (17.53%). Sixty per cent respondents did not use SGADs in laparoscopic surgery. Disposable SGADs were reused by 77.28% respondents. Oropharyngeal seal and intracuff pressures were not measured by 86.91% and 56.92% respondents, respectively. Difficulty in size selection (84.19%), securing position (82.22%) and maintaining unobstructed ventilation (78.76%) were common problems encountered while using SGADs.Conclusion:Although there is a widespread use of second-generation SGADs in Indian paediatric anaesthesia, safe practices such as using capnography, measurement of oropharyngeal seal pressure, cuff pressure and appropriate disinfection are lacking.

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A comparison of 3 ventilation strategies in children younger than 1 year using a Proseal laryngeal mask airway: a randomized controlled trial

Cited by 8 publications

References 16 publications

An in vitro analysis of the dead space in 5 supraglottic airway devices intended for use in small children and infants

An in vitro analysis of the dead space in 5 supraglottic airway devices intended for use in small children and infants

A comparison of the breathing apparatus deadspace associated with a supraglottic airway and endotracheal tube using volumetric capnography in young children

Current practice patterns of supraglottic airway device usage in paediatric patients amongst anaesthesiologists: A nationwide survey

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