Usability and performance characteristics of the pediatric air-Q® intubating laryngeal airway

Whyte, Simon; Cooke, Erin; Malherbe, Stephan

doi:10.1007/s12630-013-9918-6

Cited by 17 publications

(15 citation statements)

References 14 publications

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“…The values we showed in our results are comparable to previous leak pressures reported with the CobraPLA[ 13 25 ] and the Air-Q. [ 10 26 ] It has been previously shown that a higher airway sealing pressure does not imply a better anatomic position of the SAD. [ 27 ] Since the fiber optic glottic views obtained with both devices were comparable, it is clear that the higher ALP produced by the CobraPLA is not due to better anatomic fitness of the device.…”

Section: Discussionsupporting

confidence: 91%

Comparison of the air-Q intubating laryngeal airway and the cobra perilaryngeal airway as conduits for fiber optic-guided intubation in pediatric patients

2014

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Background:One of the methods proposed in cases of difficult airway management in children is using a supraglottic airway device as a conduit for tracheal intubation. The aim of this study was to compare the efficacy of the Air-Q Intubating Laryngeal Airway (Air-Q) and the Cobra Perilaryngeal Airway (CobraPLA) to function as a conduit for fiber optic-guided tracheal intubation in pediatric patients.Materials and Methods:A total of 60 children with ages ranging from 1 to 6 years, undergoing elective surgery, were randomized to have their airway managed with either an Air-Q or CobraPLA. Outcomes recorded were the success rate, time and number of attempts required for fiber optic-guided intubation and the time required for device removal after intubation. We also recorded airway leak pressure (ALP), fiber optic grade of glottic view and occurrence of complications.Results:Both devices were successfully inserted in all patients. The intubation success rate was comparable with the Air-Q and the CobraPLA (96.7% vs. 90%), as was the first attempt success rate (90% vs. 80%). The intubation time was significantly longer with the CobraPLA (29.5 ± 10.9 s vs. 23.2 ± 9.8 s; P < 0.05), but the device removal time was comparable in the two groups. The CobraPLA showed a significantly higher ALP (20.8 ± 5.2 cmH2O vs. 16.3 ± 4.5 cmH2O; P < 0.001), but the fiber optic grade of glottic view was comparable with the two devices. The CobraPLA was associated with a significantly higher incidence of blood staining of the device on removal and post-operative sore throat.Conclusion:Both the Air-Q and CobraPLA can be used effectively as a conduit for fiber optic-guided tracheal intubation in children. However, the Air-Q proved to be superior due to a shorter intubation time and less airway morbidity compared with the CobraPLA.

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Section: Discussionsupporting

confidence: 91%

Comparison of the air-Q intubating laryngeal airway and the cobra perilaryngeal airway as conduits for fiber optic-guided intubation in pediatric patients

2014

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“…In our previous study in children <10 kg, we found higher OLP with the air-Q as compared with the flexible laryngeal mask airway (8). Moreover, use of the air-Q in infants and small children (size 1.0, 1.5) was found to provide higher OLP than that in older children (size 2.0, 2.5) (11). The consistency with which relatively higher OLP is found with the use of the air-Q in infants may possibly be due to its larger cuff and improved cuff design (7) with inclusion of ramp.…”

Section: Discussionmentioning

confidence: 65%

Comparison of air‐Q and Ambu Aura‐i for controlled ventilation in infants: a randomized controlled trial

Darlong

Biyani

Baidya

et al. 2015

Pediatric Anesthesia

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“…The leak pressures with the air-Q in this study are consistent with those in other studies using this device in children. 10,12,25,26 The leak pressures of the i-gel appear to be lower than what has been reported in systematic reviews and meta-analyses in children. 14,15 It is possible that operator inexperience may have contributed to the lower airway leak pressures associated with the i-gel.…”

Section: Discussionmentioning

confidence: 70%

Comparaison randomisée entre les voies aériennes supraglottiques i-gel™ et air-Q™ quand elles sont utilisées par des résidents en anesthésiologie comme conduits pour intubation trachéale chez des enfants

Jagannathan

Sohn

Ramsey

et al. 2014

Can J Anesth/J Can Anesth

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Purpose Supraglottic airways are commonly used as conduits for fibreoptic bronchoscopy (FOB)-guided intubation in pediatric patients. We hypothesized that anesthesiology trainees with limited prior experience with FOB-guided intubation through a supraglottic airway in children would intubate the trachea faster through the air-Q TM supraglottic airway than through the i-gel TM . Methods Ninety-six children aged one month to six years were randomized to receive either the i-gel or air-Q for FOB-guided tracheal intubation by anesthesiology trainees. Time for successful tracheal intubation was the primary endpoint. Secondary endpoints included: time for device insertion, number of attempts for successful device insertion, airway leak pressures, FOB grade of laryngeal view, total number of attempts for tracheal intubation, time for removal of the device after tracheal intubation, and associated complications. Results The median (interquartile range [IQR]) times to successful tracheal intubation for the air-Q (62.5 [47.9-77] sec) and the i-gel (55.9 [48.5-81.8] sec) were not significantly different (median difference 6.6 sec; 95% confidence interval [CI] -13.3 to 8.7; P = 0.53). The median (IQR) time to insertion for the air-Q (16.7 [14.4-20.0] sec) was shorter than for the i-gel (19.6 [16.7-23.0] sec) (median difference 2.9 sec; 95% CI 0.8 to 4.7; P = 0.005). There were no differences between devices with respect to airway leak pressures, success rates, and time to removal. Compared with the air-Q, the i-gel was associated with more problems during device removal after tracheal intubation, including breakage of the tracheal tube pilot balloon (n = 0 vs n = 13, respectively; P \ 0.001), inadvertent extubation (n = 1 vs n = 5, respectively; P \ 0.001), and difficulty controlling the tracheal tube (n = 0 vs n = 21, respectively; P \ 0.001).Author contributions Narasimhan Jagannathan, Lisa Sohn, Andrea Huang, and Luis Sequera-Ramos participated in the conception and design of the study. Narasimhan Jagannathan, Lisa Sohn, Melissa Ramsey, Andrea Huang, Amod Sawardekar, and Loryn Kromrey participated in acquiring the data. Narasimhan Jagannathan, Andrea Huang, and Gildasio S. De Oliveira participated in the analysis of the data. Narasimhan Jagannathan, Lisa Sohn, Andrea Huang, and Gildasio S. De Oliveira participated in the interpretation of the data. Narasimhan Jagannathan, Lisa Sohn, Melissa Ramsey, Luis Sequera-Ramos, and Gildasio S. De Oliveira contributed to drafting the article. Conclusions Contrary to our hypothesis, both the air-Q and i-gel supraglottic airways served as effective conduits for FOB-guided tracheal intubation in children when performed by trainees with limited prior experience. The i-gel, however, was associated with more problems during device removal following tracheal intubation. This study was registered at http://clinicaltrials.gov/show/NCT02189590. RésuméObjectif Les voies aériennes supraglottiques sont fréquemment utilisées comme conduits pour l'intubation guidée par bronchoscopie à fi...

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Usability and performance characteristics of the pediatric air-Q® intubating laryngeal airway

Cited by 17 publications

References 14 publications

Comparison of the air-Q intubating laryngeal airway and the cobra perilaryngeal airway as conduits for fiber optic-guided intubation in pediatric patients

Comparison of the air-Q intubating laryngeal airway and the cobra perilaryngeal airway as conduits for fiber optic-guided intubation in pediatric patients

Comparison of air‐Q and Ambu Aura‐i for controlled ventilation in infants: a randomized controlled trial

Comparaison randomisée entre les voies aériennes supraglottiques i-gel™ et air-Q™ quand elles sont utilisées par des résidents en anesthésiologie comme conduits pour intubation trachéale chez des enfants

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