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A comparison of supraglottic devices in pediatric patients
BACKGROUND: When managing patients with a difficult airway, supraglottic airways (SGAs) have been used as rescue devices or to serve as a conduit for endotracheal intubation. The current study compares various clinical outcomes, including the bronchoscopic view of the glottis when using 2 SGAs, the...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6171511/ https://www.ncbi.nlm.nih.gov/pubmed/30319293 http://dx.doi.org/10.2147/MDER.S177866 |
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author | Krishna, Senthil G Syed, Faizaan Hakim, Mohammed Hakim, Mumin Tumin, Dmitry Veneziano, Giorgio C Tobias, Joseph D |
author_facet | Krishna, Senthil G Syed, Faizaan Hakim, Mohammed Hakim, Mumin Tumin, Dmitry Veneziano, Giorgio C Tobias, Joseph D |
author_sort | Krishna, Senthil G |
collection | PubMed |
description | BACKGROUND: When managing patients with a difficult airway, supraglottic airways (SGAs) have been used as rescue devices or to serve as a conduit for endotracheal intubation. The current study compares various clinical outcomes, including the bronchoscopic view of the glottis when using 2 SGAs, the Air-Q(®) laryngeal mask airway (LMA) and the i-gel(®) SGA, in pediatric patients. METHODS: Patients ≤18 years of age were prospectively randomized to receive either the Air-Q(®) LMA or the i-gel(®) SGA. Following SGA placement, a flexible fiberoptic bronchoscope was inserted through the SGA to visualize the glottis. Time taken to obtain the bronchoscopic view and place the SGA, and the ability to seal the airway at 20 cmH(2)O were compared. The bronchoscopic view obtained was graded as follows: 1) glottic aperture seen completely; 2) glottic aperture seen partially with visual obstruction <50%; 3) glottic aperture seen, but visual obstruction >50%; and 4) glottic aperture not seen. RESULTS: Fifty patients were enrolled and 48 (22/26 male/female) were included in the analysis. Median age was 13 years (IQR: 7, 16) and median weight was 49 kg (IQR: 25, 70). The Air-Q(®) LMA and i-gel(®) SGA groups did not differ in device placement time (median of 19 vs 21 seconds; 95% CI of difference in medians: − 2 to 7; P=0.331), the time to achieve fiberoptic view of the glottis (median of 25 vs 21 seconds; 95% CI of difference: − 9 to 8; P=0.489) or the grade of the bronchoscopic view of the airway. Eight Air-Q(®) and 6 i-gel(®) supraglottic devices sealed the airway at 20 cmH(2)O. DISCUSSION: The time required for successful placement of the SGA, the time required for bronchoscopic view, and the quality of bronchoscopic view through the Air-Q(®) LMA and the i-gel(®) SGA did not differ. |
format | Online Article Text |
id | pubmed-6171511 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-61715112018-10-12 A comparison of supraglottic devices in pediatric patients Krishna, Senthil G Syed, Faizaan Hakim, Mohammed Hakim, Mumin Tumin, Dmitry Veneziano, Giorgio C Tobias, Joseph D Med Devices (Auckl) Original Research BACKGROUND: When managing patients with a difficult airway, supraglottic airways (SGAs) have been used as rescue devices or to serve as a conduit for endotracheal intubation. The current study compares various clinical outcomes, including the bronchoscopic view of the glottis when using 2 SGAs, the Air-Q(®) laryngeal mask airway (LMA) and the i-gel(®) SGA, in pediatric patients. METHODS: Patients ≤18 years of age were prospectively randomized to receive either the Air-Q(®) LMA or the i-gel(®) SGA. Following SGA placement, a flexible fiberoptic bronchoscope was inserted through the SGA to visualize the glottis. Time taken to obtain the bronchoscopic view and place the SGA, and the ability to seal the airway at 20 cmH(2)O were compared. The bronchoscopic view obtained was graded as follows: 1) glottic aperture seen completely; 2) glottic aperture seen partially with visual obstruction <50%; 3) glottic aperture seen, but visual obstruction >50%; and 4) glottic aperture not seen. RESULTS: Fifty patients were enrolled and 48 (22/26 male/female) were included in the analysis. Median age was 13 years (IQR: 7, 16) and median weight was 49 kg (IQR: 25, 70). The Air-Q(®) LMA and i-gel(®) SGA groups did not differ in device placement time (median of 19 vs 21 seconds; 95% CI of difference in medians: − 2 to 7; P=0.331), the time to achieve fiberoptic view of the glottis (median of 25 vs 21 seconds; 95% CI of difference: − 9 to 8; P=0.489) or the grade of the bronchoscopic view of the airway. Eight Air-Q(®) and 6 i-gel(®) supraglottic devices sealed the airway at 20 cmH(2)O. DISCUSSION: The time required for successful placement of the SGA, the time required for bronchoscopic view, and the quality of bronchoscopic view through the Air-Q(®) LMA and the i-gel(®) SGA did not differ. Dove Medical Press 2018-10-01 /pmc/articles/PMC6171511/ /pubmed/30319293 http://dx.doi.org/10.2147/MDER.S177866 Text en © 2018 Krishna et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Krishna, Senthil G Syed, Faizaan Hakim, Mohammed Hakim, Mumin Tumin, Dmitry Veneziano, Giorgio C Tobias, Joseph D A comparison of supraglottic devices in pediatric patients |
title | A comparison of supraglottic devices in pediatric patients |
title_full | A comparison of supraglottic devices in pediatric patients |
title_fullStr | A comparison of supraglottic devices in pediatric patients |
title_full_unstemmed | A comparison of supraglottic devices in pediatric patients |
title_short | A comparison of supraglottic devices in pediatric patients |
title_sort | comparison of supraglottic devices in pediatric patients |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6171511/ https://www.ncbi.nlm.nih.gov/pubmed/30319293 http://dx.doi.org/10.2147/MDER.S177866 |
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