A comparison of four methods for assessing oropharyngeal leak pressure with the laryngeal mask airway (LMA<sup>™</sup>) in paediatric patients

Lopez-Gil, M.; Brimacombe, J.; Keller, Christian

doi:10.1046/j.1460-9592.2001.00649.x

Cited by 90 publications

(83 citation statements)

References 8 publications

(8 reference statements)

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“…With the CLMA in children, manometric stability and auscultation produce similar leak pressure results. 22 It is possible that this may not apply to the PLMA. In adults, manometric stability produces higher leak pressures than does auscultation for the CLMA.…”

Section: Discussionmentioning

confidence: 99%

Comparison of laryngeal mask airway (LMA)-Proseal™ and the LMA-Classic™ in ventilated children receiving neuromuscular blockade

Lardner

Cox

Ewen

et al. 2008

Can J Anesth/J Can Anesth

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CAN J ANESTH 55: 1 www.cja-jca.org Januar y, 2008Purpose: To determine whether a functional difference exists between the size 2 laryngeal mask airway (LMA)-Classic™ (CLMA) and LMA-Proseal™ (PLMA) in anesthetized children who have received neuromuscular blockade. Airway leak during intermittent positive pressure ventilation (IPPV) and adequacy of fibreoptic laryngeal view were the primary study outcomes. Methods:A randomized, controlled, single-blinded study of 51 ASA I or II children weighing 10-20 kg was undertaken. The anesthetic technique was standardized. Following insertion of the LMA and cuff inflation to 60 cm H 2 O, we measured oropharyngeal leak pressure and gastric insufflation and leak fraction during IPPV, and evaluated the adequacy of fibreoptic view.Results: Oropharyngeal leak pressure measured by neck auscultation was higher for the PLMA compared to the CLMA (23.7 vs 16.5 cm H 2 O, P = 0.009) but, when measured by the inspiratory hold maneuver was not significantly different (24.8 vs 20.3 cm H 2 O, respectively, P = 0.217). Leak fraction values were similar for the CLMA and the PLMA (21.2%. vs 13.3%, respectively, P = 0.473). A satisfactory view of the larynx was obtained more frequently in the PLMA group (21/25 vs 10/25, P = 0.003). Gastric insufflation during leak determination was more common with the CLMA (12/26 vs 2/25 CLMA vs PLMA, respectively, P = 0.006). Conclusion:In children undergoing IPPV with neuromuscular blockade, the size 2 PLMA is associated with a higher leak pressure by auscultation and less gastric insufflation compared to the CLMA. Leak pressures assessed by manometric stability are similar with these two devices. The improved fibreoptic view of the larynx through the PLMA may be advantageous for bronchoscopy. CLMA (23,7 vs 16,5 cm H 2 O, P = 0,009) ; toutefois, lorsque celle-ci a été mesurée par manoeuvre de retenue respiratoire, il n'y a pas eu de différence significative (24,8 vs 20,3 cm H 2 O, respectivement, P = 0,217). Les valeurs de fraction de fuite étaient semblables avec le CLMA et le PLMA (21,2 % vs 13,3 %, respectivement, P = 0,473). Une vision satisfaisante du larynx a été plus fréquemment obtenue dans le groupe PLMA (21/25 vs 10/25, P = 0,003). L'insufflation gastrique pendant la détermination de la fuite a été plus fréquemment observée dans le groupe CLMA (12/26 vs 2/25 CLMA vs PLMA, respectivement, P = 0,006).

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Section: Discussionmentioning

confidence: 99%

Comparison of laryngeal mask airway (LMA)-Proseal™ and the LMA-Classic™ in ventilated children receiving neuromuscular blockade

Lardner

Cox

Ewen

et al. 2008

Can J Anesth/J Can Anesth

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“…Outcomes measured were airway leak pressure, ease and time for insertion, fibreoptic examination, incidence of gastric insufflation and complications. Median (IQR [range]) time to successful device placement was faster with the air-Q SP (12 (10-15 [5][6][7][8][9][10][11][12][13][14][15][16][17][18])) s than with the LMA-Unique (14 (12-17 [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]) s; p = 0.05). There were no statistically significant differences between the air-Q SP and LMA-Unique in initial airway leak pressures (16 (14-18 [10- …”

Section: Discussionmentioning

confidence: 99%

“…To determine the leak pressure, the expiratory valve was closed with a fresh gas flow of 3 l.min )1 until equilibrium was reached [9] (not allowed to exceed 40 cmH 2 O), and then released completely. Auscultation with a stethoscope was performed over the epigastrium during leak pressure testing to detect the occurrence of gastric insufflation [10].…”

Section: Methodsmentioning

confidence: 99%

A randomised comparison of the self‐pressurised air‐Q^TM intubating laryngeal airway with the LMA Unique^TM in children*

et al. 2012

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“…The expiratory valve was closed with a fresh gas flow of 3 l.min À1 until equilibrium was reached [9], and then released completely (maximum of 40 cmH 2 O). Airway leak pressure measurements were repeated again at 10 min after the initial leak pressure determination (after grading the laryngeal view and gastric tube placement).…”

Section: Methodsmentioning

confidence: 99%

A randomised comparison of the Ambu^® AuraGain^™ and the LMA^® supreme in infants and children

et al. 2015

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SummaryWe conducted a randomised trial in 100 children in order to compare the clinical performance of the Ambu â AuraGain TM and the LMA â Supreme * for airway maintenance during mechanical ventilation. The primary outcomes were initial and 10-min airway leak pressures. Ease, time and success rates for device and gastric tube insertion, fibreoptic grades of view, airway quality during anaesthetic maintenance, and complications were also assessed. 16-26 [12-40]) cmH 2 O, p = 0.08, respectively. Ease, time and success rates for device placement, gastric tube insertion and complications were also not significantly different. Children receiving the LMA Supreme required more airway manouevers (7 vs 1 patient, p = 0.06) to maintain a patent airway. Our results suggest that the Ambu AuraGain may be a useful alternative to the LMA Supreme, as demonstrated by comparable overall clinical performance in children.

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A comparison of four methods for assessing oropharyngeal leak pressure with the laryngeal mask airway (LMA^™) in paediatric patients

Abstract: We conclude that all four tests provide accurate and reliable information about oropharyngeal leak pressure in children.

Cited by 90 publications

References 8 publications

Comparison of laryngeal mask airway (LMA)-Proseal™ and the LMA-Classic™ in ventilated children receiving neuromuscular blockade

Comparison of laryngeal mask airway (LMA)-Proseal™ and the LMA-Classic™ in ventilated children receiving neuromuscular blockade

A randomised comparison of the self‐pressurised air‐Q^TM intubating laryngeal airway with the LMA Unique^TM in children*

A randomised comparison of the Ambu^® AuraGain^™ and the LMA^® supreme in infants and children

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A comparison of four methods for assessing oropharyngeal leak pressure with the laryngeal mask airway (LMA™) in paediatric patients

Abstract: We conclude that all four tests provide accurate and reliable information about oropharyngeal leak pressure in children.

Cited by 90 publications

References 8 publications

Comparison of laryngeal mask airway (LMA)-Proseal™ and the LMA-Classic™ in ventilated children receiving neuromuscular blockade

Comparison of laryngeal mask airway (LMA)-Proseal™ and the LMA-Classic™ in ventilated children receiving neuromuscular blockade

A randomised comparison of the self‐pressurised air‐QTM intubating laryngeal airway with the LMA UniqueTM in children*

A randomised comparison of the Ambu® AuraGain™ and the LMA® supreme in infants and children

Contact Info

Product

Resources

About

A comparison of four methods for assessing oropharyngeal leak pressure with the laryngeal mask airway (LMA^™) in paediatric patients

A randomised comparison of the self‐pressurised air‐Q^TM intubating laryngeal airway with the LMA Unique^TM in children*

A randomised comparison of the Ambu^® AuraGain^™ and the LMA^® supreme in infants and children