Laryngeal mask airway‐aided fiberoptic tracheal intubation in infant – a modified technique

Khan, Rashid M.; Sharma, Pradeep; Kaul, Naresh

doi:10.1111/j.1460-9592.2009.03148.x

Cited by 5 publications

(9 citation statements)

References 5 publications

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“…Although there are not manufacturer recommendations for LMA-supreme, LMAclassic and LMA-proseal, they have been commonly used as conduits for intubation in children in cases when no special SADs were available. 5,7,15,16 Similarly, in our study, the feasibility of intubation with standard uncuffed 3.0 mm ETT through an LMA-proseal size 1 was statistically comparable with i-gel size 1. Also, we found the feasibility of intubation with up to standard uncuffed 3.5 mm ETT through LMAclassic size 1.5 was statistically comparable with i-gel size 1.5.…”

Section: Discussionsupporting

confidence: 74%

“…3,4 The presence of a SAD could additionally provide a guide for the FOB and diminish blurring of the vision due to blood and secretions. 5 There are specially designed SADs that act as conduits for intubation, however many types of SADs including the traditional LMA (Laryngeal Mask Airway) have been used with success for this purpose for years. 3,6,7 The main restriction of the technique is the difficulty to pass the endotracheal tube through the SAD, especially in newborns and infants.…”

mentioning

confidence: 99%

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Comparison of i-gel, LMA-supreme, LMA-classic and LMAproseal as conduits of endotracheal intubation in newborns and infants: A manikin study

Ankay-Yılbaş¹,

Başaran²,

Üzümcügil³

et al. 2019

Turk J Pediatr

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Many types of supraglottic airway devices (SAD) including the traditional LMA (Laryngeal Mask Airway) are commonly used as conduits for intubation in pediatric patients with difficult airway. The aim of this study was to evaluate the feasibility of four types of commonly used neonatal and infant sized SADs as conduits of intubation. Fiberoptic-guided tracheal intubation with uncuffed, cuffed and armored uncuffed endotracheal tubes (ETT) sized between 2.5 and 4.5 through four commonly used types of size 1 and 1.5 SADs (i-gel, LMA-classic, LMA-supreme, LMA-proseal) were performed by two investigators on an infant manikin. The investigators scored two main outcomes with a 5-point scale: 1) passage of ETT during intubation through the SAD, and 2) passage of SAD over the ETT during SAD removal. The differences between the study groups were evaluated using the Bonferroniadjusted Mann-Whitney U test and p<0.0083 was considered as statistically significant according to Bonferroni correction. i-gel sizes 1 and 1.5 both performed better as conduits for fiberoptic-guided intubation compared with LMA-proseal, LMA-classic and LMA-supreme with most of the uncuffed ETTs investigated (p<0.0083). We found i-gel sizes 1 and 1.5 easily feasible to use even with uncuffed ETTs with an inner diameter of 3.5 mm and 4.5 mm, respectively. i-gel was the only SAD that was feasible for use as a conduit for armored ETTs. The passage of cuffed ETTs was problematic with all types of studied SADs. In conclusion; the choice of i-gel as a conduit for intubation could be safer than LMA-classic, LMA-supreme and LMA-proseal.

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Section: Discussionsupporting

confidence: 74%

mentioning

confidence: 99%

Comparison of i-gel, LMA-supreme, LMA-classic and LMAproseal as conduits of endotracheal intubation in newborns and infants: A manikin study

Ankay-Yılbaş¹,

Başaran²,

Üzümcügil³

et al. 2019

Turk J Pediatr

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show abstract

“…S ir —Khan et al. (1) reported an inadvertent dislodgement of a tracheal tube (and the loss of a clear airway) after successful fiberoptic intubation through a laryngeal mask, in an infant with unexpected difficult intubation and difficult facemask ventilation. A clear airway was lost when they attempted to remove the laryngeal mask over two tracheal tubes, proximal one of which used as a stabilizing rod.…”

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confidence: 99%

Removal of the laryngeal mask after tracheal intubation through it

Asai

2010

Pediatric Anesthesia

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“…S ir —I recently read the articles by Drs Khan et al. (1) and Dr Asai (2). They have discussed their techniques of preventing the dislodgement of oral tracheal tube during the removal of laryngeal mask.…”

mentioning

confidence: 99%

Prevention of tracheal tube dislodgement and provision for reintubation during removal of Laryngeal Mask Airway

Sharma

2010

Pediatric Anesthesia

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Laryngeal mask airway‐aided fiberoptic tracheal intubation in infant – a modified technique

Cited by 5 publications

References 5 publications

Comparison of i-gel, LMA-supreme, LMA-classic and LMAproseal as conduits of endotracheal intubation in newborns and infants: A manikin study

Comparison of i-gel, LMA-supreme, LMA-classic and LMAproseal as conduits of endotracheal intubation in newborns and infants: A manikin study

Removal of the laryngeal mask after tracheal intubation through it

Prevention of tracheal tube dislodgement and provision for reintubation during removal of Laryngeal Mask Airway

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