A pilot evaluation of the 3gLM-R – A new supraglottic airway device

Michálek, Pavel; Jindrova, B.; Kříž, Petr; Stříteský, Martin; Sedlář, Martin

doi:10.1016/j.advms.2015.02.001

Cited by 6 publications

(6 citation statements)

References 19 publications

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“…Ischemia of the tongue has been described in association with the intubating LMA after prolonged insertion [ 76 ] and also with the cLMA—again after a period of prolonged insertion [ 77 ]. A vacuum-like effect has been suggested to cause a hematoma on the lateral edge of the tongue following insertion of the 3gLM airway [ 78 ].…”

Section: Complicationsmentioning

confidence: 99%

Complications Associated with the Use of Supraglottic Airway Devices in Perioperative Medicine

Michálek

Donaldson

Vobrubová

et al. 2015

BioMed Research International

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Supraglottic airway devices are routinely used for airway maintenance in elective surgical procedures where aspiration is not a significant risk and also as rescue devices in difficult airway management. Some devices now have features mitigating risk of aspiration, such as drain tubes or compartments to manage regurgitated content. Despite this, the use of these device may be associated with various complications including aspiration. This review highlights the types and incidence of these complications. They include regurgitation and aspiration of gastric contents, compression of vascular structures, trauma, and nerve injury. The incidence of such complications is quite low, but as some carry with them a significant degree of morbidity the need to follow manufacturers' advice is underlined. The incidence of gastric content aspiration associated with the devices is estimated to be as low as 0.02% with perioperative regurgitation being significantly higher but underreported. Other serious, but extremely rare, complications include pharyngeal rupture, pneumomediastinum, mediastinitis, or arytenoid dislocation. Mild short-lasting adverse effects of the devices have significantly higher incidence than serious complications and involve postoperative sore throat, dysphagia, pain on swallowing, or hoarseness. Devices may have deleterious effect on cervical mucosa or vasculature depending on their cuff volume and pressure.

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Section: Complicationsmentioning

confidence: 99%

Complications Associated with the Use of Supraglottic Airway Devices in Perioperative Medicine

Michálek

Donaldson

Vobrubová

et al. 2015

BioMed Research International

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“…[9–11,14] However, at high inspiratory pressures, SADs do not ensure airway sealing. Furthermore, SADs are not recommended in the practice of asynchronous resuscitation owing to the risk of regurgitation and aspiration of gastric contents.…”

Section: Discussionmentioning

confidence: 99%

“…Outside of the hospital, the ability of paramedics to perform direct laryngoscopy in children has been moderately effective, ranging from 63% to 80%. [6–8] Alternative airway management methods, such as Supraglottic Airway Devices (SADs), may be useful in an emergency medical situation [9–11] (Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

Exchange of supraglottic airways for endotracheal tube using the Eschmann Introducer during simulated child resuscitation

Szarpak

Truszewski²,

Vitale³

et al. 2017

Medicine

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Background:The aim of this study was to examine the application of the Eschmann tracheal tube introducer (ETTI) with 4 types of supraglottic airway devices (SADs) using a child-manikin.Methods:A total of 79 paramedics were asked to exchange the 4 SADs for an endotracheal tube with the ETTI in 3 different scenarios using a randomized crossover study format: normal airway without chest compression; normal airway with uninterrupted chest compression; and difficult airway with uninterrupted chest compression. The primary outcome was time to SAD exchange, with the secondary outcome measuring the success of SAD exchange. Each attempt was assessed by a trained assistant.Results:The mean exchange times for LMA, Cobra PLA, Air-Q, and SALT were as follows: 21, 23, 21, and 18, respectively for Scenario A; 23, 27, 22.5, and 21 for Scenario B; and 23, 28, 23, and 23 for Scenario C. The percent efficacy of SADs exchange with LMA, Cobra PLA, Air-Q and SALT were 98.7%, 94.9%, 100%, and 100% for scenario A; 98.7%, 88.6%, 98.7%, and 97.5% for scenario B; and 93.7%, 87.3%, 94.9%, and 93.7% for scenario C.Conclusions:In this model of pediatric resuscitation, the SAD exchange using an ETTI has (LMA, Cobra PLA, Air-Q and SALT) proved to be effective in paramedics with no previous experience. Furthermore, experimental findings indicated that SAD exchange can be achieved without interrupting chest compression.

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“…However, there has been no study to date published comparing these 2nd-generation supraglottic airway devices, with supposed lower incidence of gastric content aspiration in relation to airway management in the field, and the results of this study could become a starting point for further research projects evaluating the role of these devices in military medicine. Finally, few new devices, such as the 3gLM airway [ 24 ] or CPV Guardian Laryngeal Mask [ 25 ], have been invented in the last years and they may be used for similar comparative studies in the future.…”

Section: Limitationsmentioning

confidence: 99%

Comparison of Five 2nd-Generation Supraglottic Airway Devices for Airway Management Performed by Novice Military Operators

Henlín

Soták

Kovaříček

et al. 2015

BioMed Research International

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Objectives. Five different second-generation supraglottic airway devices, ProSeal LMA, Supreme LMA, i-gel, SLIPA, and Laryngeal Tube Suction-D, were studied. Operators were inexperienced users with a military background, combat lifesavers, nurses, and physicians. Methods. This was a prospective, randomized, single-blinded study. Devices were inserted in the operating room in low light conditions after induction of general anesthesia. Primary outcome was successful insertion on the first attempt while secondary aims were insertion time, number of attempts, oropharyngeal seal pressure, ease of insertion, fibre optic position of device, efficacy of ventilation, and intraoperative trauma or regurgitation of gastric contents. Results. In total, 505 patients were studied. First-attempt insertion success rate was higher in the Supreme LMA (96%), i-gel (87.9%), and ProSeal LMA (85.9%) groups than in the Laryngeal Tube Suction-D (80.6%) and SLIPA (69.4%) groups. Insertion time was shortest in the Supreme LMA (70.4 ± 32.5 s) and i-gel (74.4 ± 41.1 s) groups (p < 0.001). Oropharyngeal seal pressures were higher in the Laryngeal Tube Suction-D and ProSeal LMA groups than in other three devices. Conclusions. Most study parameters for the Supreme LMA and i-gel were found to be superior to the other three tested supraglottic airway devices when inserted by novice military operators.

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A pilot evaluation of the 3gLM-R – A new supraglottic airway device

Cited by 6 publications

References 19 publications

Complications Associated with the Use of Supraglottic Airway Devices in Perioperative Medicine

Complications Associated with the Use of Supraglottic Airway Devices in Perioperative Medicine

Exchange of supraglottic airways for endotracheal tube using the Eschmann Introducer during simulated child resuscitation

Comparison of Five 2nd-Generation Supraglottic Airway Devices for Airway Management Performed by Novice Military Operators

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