Evaluation of chest compression effect on airway management with air-Q®, aura-i®, i-gel®, and Fastrack® intubating supraglottic devices by novice physicians: a randomized crossover simulation study

Komasawa, Nobuyasu; Ueki, Ryusuke; Kaminoh, Yoshiroh; Nishi, Shinichi

doi:10.1007/s00540-014-1802-1

Cited by 24 publications

(24 citation statements)

References 23 publications

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“…[1,4,11,13,14,21–29] All studies were randomized crossover trials except 1 with parallel design. [21] The included articles contained several comparisons between the i-gel and other supraglottic airways as follows: 4 comparisons with the LMA Classic (LMA North America, Inc., San Diego, USA), [11,22,25,29] 5 with the LMA Fastrach (Laryngeal Mask, Prodol Meditec, Spain), [13,14,24,27,28] 3 with the LMA Proseal (LMA North America, Inc., San Diego, USA), [1,14,23] 3 with the LMA Supreme, [13,23,24] 5 with the LMA Unique (LMA North America, Inc., San Diego, USA), [1,4,14,23,24] 7 with the laryngeal tube (King-LT-D, VBM, Sulz, Germany), [1,4,13,14,21,22,24] 5 with the Combitube (Covidien, Mansfield, MA, USA), [1,4,13,14,24] 4 with the EasyTube (Teleflexmedical Ruesch, Research Triangle Park, NC, USA), [1,4,13,24] 1 with the SoftSeal (Smiths Medical International Ltd, Ashford, Kent, UK), [26] 1 with the AuraOnce (Ambu, Ballerup, Denmark), [26] 1 with the aura-i, [27] and 1 with the air-Q (Cookgas LLC, Mercury Medical, USA). [27] Characteristics of the included articles are summarized in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

Comparison of the i-gel and other supraglottic airways in adult manikin studies

Nam²,

Lee³

et al. 2017

Medicine

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Background:The i-gel has a gel-like cuff composed of thermoplastic elastomer that does not require cuff inflation. As the elimination of cuff inflation may shorten insertion time, the i-gel might be a useful tool in emergency situations requiring prompt airway care. This systematic review and meta-analysis of previous adult manikin studies for inexperienced personnel was performed to compare the i-gel with other supraglottic airways.Methods:We searched PubMed, the Cochrane Library, and EMBASE for eligible randomized controlled trials (RCTs) published before June 2015, including with a crossover design, using the following search terms: “i-gel,” “igel,” “simulation,” “manikin,” “manikins,” “mannequin,” and “mannequins.” The primary outcomes of this review were device insertion time and the first-attempt success rate of insertion.Results:A total of 14 RCTs were included. At the initial assessment without difficult circumstances, the i-gel had a significantly shorter insertion time than the LMA Classic, LMA Fastrach, LMA Proseal, LMA Unique, laryngeal tube, Combitube, and EasyTube. However, a faster insertion time of the i-gel was not observed in comparisons with the LMA Supreme, aura-i, and air-Q. In addition, the i-gel did not show the better results for the insertion success rate when compared to other devices.Conclusion:The findings of this meta-analysis indicated that inexperienced volunteers placed the i-gel more rapidly than other supraglottic airways with the exception of the LMA Supreme, aura-i, and air-Q in manikin studies. However, the quicker insertion time is clinically not relevant. The unapparent advantage regarding the insertion success rate and the inherent limitations of the simulation setting indicated that additional evidence is necessary to confirm these advantages of the i-gel in an emergency setting.

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Section: Resultsmentioning

confidence: 99%

Comparison of the i-gel and other supraglottic airways in adult manikin studies

Nam²,

Lee³

et al. 2017

Medicine

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“…After intubation through the Aura-i™, it was possible to successfully pass a gastric tube behind the Aura-i™ laryngeal mask with its cuff deflated [11]. A simulation study by novice physicians found that chest compressions did not decrease the ventilation and intubation success rates of four intubating supraglottic airway devices, the AURA-i®, air-Q®, i-gel®, and Fastrack® during cardiopulmonary resuscitation [12]. …”

Section: Discussionmentioning

confidence: 99%

The AMBU® Aura-i™ Laryngeal Mask and LMA Supreme™: A Randomized Trial of Clinical Performance and Fibreoptic Positioning in Unparalysed, Anaesthetised Patients by Novices

Yahaya

Teoh²,

Dintan

et al. 2016

Anesthesiology Research and Practice

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Introduction. Manikin studies' data cannot accurately be extrapolated to real-life scenarios and inherent differences in design and materials of newer products may affect their clinical performance. Methods. Hence, we compared the AMBU® Aura-i™ and LMA Supreme™ in this randomized trial involving 100 ASA 1-2 unparalysed anaesthetised patients undergoing minor gynaecological surgery. Investigators had <20 Aura-i insertions. Primary outcome was time to achieve effective ventilation and secondarily insertion parameters, oropharyngeal leak pressures (OLP), fibreoptic positioning, and pharyngeal morbidity. The position of the Ambu Aura-i was evaluated with the Ascope; the fiberoptic view of the glottis was scored on a five-point scale. Results. 43 (86%) AMBU Aura-i and 44 (88%) LMA Supremes were successfully inserted on first attempt (p = 0.59), with similar ease (p = 0.79), and comparable times to first capnogram, mean (SD) 18.2 (6.0) versus 17.3 (6.4) sec, p = 0.9. The Aura-i needed significantly less volume of air to inflate its cuff to 60 cmH2O on the manometer, 17.7 (3.5) versus 23.1 (4.4) mL, p < 0.001. Both devices exhibited similar OLP, Aura-i versus LMA Supreme, mean (SD) 28.8 (7.1) versus 27.3 (5.3) cmH2O, p = 0.24. There was no difference in ease of insertion or adjustment manoeuvres to aid ventilation. 90% of patients had good positioning of Aura-i on fibreoptic check, yielding a view of the vocal cords and epiglottis. In 5 patients (10%), the vocal cords were not seen, but ventilatory function was unaffected. Conclusions. The Aura-i handled well in novices hands, with comparable times to insert and establish ventilation, similar leak pressures, and successful first attempt insertion rates compared to the LMA Supreme.

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“…Various SGDs exist, and most have an inflatable cuff, including conventional laryngeal masks such as the ProSeal, LMA-Classic, air-Q, and LMASupreme [16]. The ProSeal has various enhanced features and differs from original laryngeal mask models such as the LMA-Classic and LMA-SoftSeal [5].…”

Section: Discussionmentioning

confidence: 99%

LMA-ProSeal insertion by novice doctors as affected by a 90° bend created by an intubating stylet: a randomized clinical trial

Ishio

Komasawa

Miyazaki

et al. 2016

Journal of Clinical Anesthesia

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Evaluation of chest compression effect on airway management with air-Q®, aura-i®, i-gel®, and Fastrack® intubating supraglottic devices by novice physicians: a randomized crossover simulation study

Abstract: This simulation study revealed the utility of intubating SGDs for airway management during chest compression.

Cited by 24 publications

References 23 publications

Comparison of the i-gel and other supraglottic airways in adult manikin studies

Comparison of the i-gel and other supraglottic airways in adult manikin studies

The AMBU® Aura-i™ Laryngeal Mask and LMA Supreme™: A Randomized Trial of Clinical Performance and Fibreoptic Positioning in Unparalysed, Anaesthetised Patients by Novices

LMA-ProSeal insertion by novice doctors as affected by a 90° bend created by an intubating stylet: a randomized clinical trial

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