A Clinical Evaluation of the Intubating Laryngeal Airway as a Conduit for Tracheal Intubation in Children

Jagannathan, Narasimhan; Kozlowski, Ryan J.; Sohn, Lisa; Langen, Kenneth E.; Roth, Andrew G.; Mukherji, Isabella I.; Kho, Melanie F.; Suresh, Santhanam

doi:10.1213/ane.0b013e3181fe0408

Cited by 72 publications

(85 citation statements)

References 30 publications

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“…This is consistent with a previous report of the air-Q ILA in children 10,11 and higher than the 88% reported with the air-Q ILA in adults. 12 The first attempt success rate is also similar to the 92-100% reported for PLMA sizes 1.5-2.5.…”

Section: Discussionsupporting

confidence: 92%

“…Our data on neutral OLP values and, commensurately, our V T max values for the air-Q ILA are lower than existing published data for the PLMA. [2][3][4]14 Our findings for air-Q ILA sizes 1.5 and 2.0 are similar to those previously published, 10,11 where the mean (standard deviation [SD]) OLP was 17.5 (6.4) cm H 2 O and 18.5 (1.6) cm H 2 O for size 1.5 and 15.7 (4.3) cm H 2 O for size 2.0. Our OLP findings for size 1 were higher than those by Sinha et al 11 who reported a mean (SD) OLP of 18.5 (2.1) cm H 2 O. Oropharyngeal leak pressures increase when the patient's neck is in the flexed position, a phenomenon also described with the PLMA.…”

Section: Discussionsupporting

confidence: 90%

“…The percentage of subjects with only their vocal cords visible was similar to that of Sinha et al 11 (45%) but higher than that of Jagannathan et al, 10 with 31% having only their vocal cords visible. Furthermore, at 7%, we report a much lower incidence of no fibreoptic view of the vocal cords than Jagannathan et al 10 (27%) and Sinha et al 11 (30%), the difference being most striking in the smallest air-Q ILA sizes.…”

Section: Discussionsupporting

confidence: 76%

“…This is a higher percentage than that reported by Sinha et al 11 and Jagannathan et al, 10 where only 70% and 73%, respectively, had any vocal cords visible. The percentage of subjects with only their vocal cords visible was similar to that of Sinha et al 11 (45%) but higher than that of Jagannathan et al, 10 with 31% having only their vocal cords visible.…”

Section: Discussioncontrasting

confidence: 60%

“…Whether the air-Q ILA will perform equally well in patients with a difficult airway and abnormal anatomy remains to be investigated. We 5 and others 6,10,15 have reported on the successful use of the air-Q ILA in pediatric difficult airway management. Second, some of our evaluation criteria are subjective and semi-quantitative.…”

Section: Discussionmentioning

confidence: 89%

See 4 more Smart Citations

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

Whyte

Cooke

Malherbe

2013

Can J Anesth/J Can Anesth

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Purpose The air-QÒ intubating laryngeal airway (ILA) is a supraglottic device (SGD) designed specifically to function as both a primary airway and a bridging device and conduit for fibreoptic intubation in difficult airway scenarios. This observational study evaluated the usability and performance characteristics of pediatric air-Q ILA sizes 1.0, 1.5, 2.0, and 2.5 when used as a primary airway. Methods One hundred ten children, American Society of Anesthesiologists physical status I-III and undergoing elective surgery, received a weight-appropriate air-Q ILA following induction of anesthesia. The evaluation criteria included ease of insertion, quality of ventilation, presence of gastric insufflation, oropharyngeal leak pressures

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 76%

Section: Discussioncontrasting

confidence: 60%

Section: Discussionmentioning

confidence: 89%

See 3 more Smart Citations

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

Whyte

Cooke

Malherbe

2013

Can J Anesth/J Can Anesth

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The Difficult Pediatric Airway: Management Options

Vakamudi

2014

Airway Management

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Surgical airways for trauma patients in an emergency surgical setting: 11 years’ experience at a teaching hospital in Japan

Ono¹,

Yokoyama²,

Matsumoto³

et al. 2013

J Anesth

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Purpose Airway management of trauma patients during emergency surgeries can be very difficult, and presents a challenge for anesthesiologists. Difficult airways are associated with emergency surgical airways (ESA), but little is known about ESA in the operating room. We conducted this study to clarify the present use of ESA for trauma patients in emergency surgery settings. MethodsWe performed a retrospective review of all trauma patients requiring emergency surgery under general anesthesia at our hospital from January 2002 to December 2012, and focused on ESA.Results During the study period, 15,654 trauma patients were treated at our hospital, of whom 554 (3.5%) required emergency surgery. Four of these (0.72%) received ESA as definitive airway management. Two patients with severe facial injury and distorted upper airways and one patient with penetrating neck trauma received open standard tracheostomies (OST). These three patients received OST as the initial approach to intubation. A fourth OST was performed after several unsuccessful attempts at endotracheal intubation. No cases were classified as "cannot ventilate, cannot intubate" (CVCI), and there were no complications associated with ESA. All cases had good outcomes.Statistical analysis revealed that patients with severe facial trauma (Abbreviated Injury Scale ≥ 3) received ESA at a significantly higher rate than others (p=0.015, Odds ratio: 14.1). ConclusionOne of the most important functions of anesthesiologists is risk management. We should recognize risks that can cause CVCI situations, and make proper clinical decisions, including 3 providing ESA, to assure patient safety.4

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A Clinical Evaluation of the Intubating Laryngeal Airway as a Conduit for Tracheal Intubation in Children

Cited by 72 publications

References 30 publications

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

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

The Difficult Pediatric Airway: Management Options

Surgical airways for trauma patients in an emergency surgical setting: 11 years’ experience at a teaching hospital in Japan

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