A Cross-Sectional Study Evaluating the GuardianCPVTM Supraglottic Airway Device in a Clinical Setting

Abstract

Objective: The GuardianCPV TM is a new second-generation supraglottic airway device (SAD), for which there is currently limited information on efficacy or safety. Our aim is to clarify further the efficacy of the Guardian, and to assess any potential predictors for success or failure of insertion. Methods:We conducted a cross-sectional pilot study over a two-month period, recruiting 67 operative cases (33 males; 34 females; weight 81.1 ± 23.0 kg) at the Northern Hospital (TNH), Victoria, Australia, that used the Guardian airway in an elective setting. For each case, the operator of the airway reported, via a voluntary questionnaire, several factors of interest: (1) the overall success rate (primary outcome); (2) ease of insertion; (3) cuff seal pressure (CSP); (4) need for repositioning of the SAD; and (5) patient, airway, operator and technique-related predictors, including past experience with the Guardian (as determined by number of times previously used) and insertion technique. Results:The overall success rate was 78%. There was a positive association between prior experience with the Guardian and subsequent success rates (p=0.049). Successful insertion was associated with greater ease with insertion (p=0.012), and greater CSPs (p<0.0001). The most popular insertion technique was sideways-and-rotate. No other patient, airway or technique-related factors had any significant impact on success rates with the Guardian. Conclusion:The Guardian SAD demonstrated similar efficacy to other SADs as reported in the literature. Prior familiarization with a new airway device is a key determinant in its successful use.