Confirmation of laryngeal mask airway placement by ultrasound examination: a pilot study

Song, Kaicheng; Yi, Jie; Liu, Wei; Huang, Shuang; Huang, Yuguang

doi:10.1016/j.jclinane.2016.06.019

Cited by 33 publications

(34 citation statements)

References 14 publications

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“…Compared with clinical tests, FOB and USG can provide detailed anatomical information, but there are also some differences between them. USG is a noninvasive, rapid and reliable device that does not intervene with the ventilation (4,5,8) . Several studies demonstrated that USG can be utilized to predict difficult intubation, and to confirm the position of endotracheal tube (10,(18)(19)(20) .…”

Section: Discussionmentioning

confidence: 99%

“…An anesthesiologist should be able to recognize quickly whether LMA is placed accurately in order to avoid such complications as mucosal damage, gastric insufflation, requirement for reinsertion, insufficient ventilation or hypoxemia (4)(5)(6)(7) . On the other hand, LMA may be placed correctly while an airway obstruction might occur for any reason.…”

Section: Introductionmentioning

confidence: 99%

“…However, even if all these clinical tests are considered to be within normal limits, LMA may not be placed correctly (4,6,9) . Therefore, the fiberoptic examination is considered the gold standard for the confirmation of accurate placement of LMA, although it is an invasive and relatively expensive method requiring interruption of the ventilation (5) . Ultrasonography (USG) is being utilized increasingly in the airway management due to advantages as its noninvasive, portable, rapid and real-time imaging features (10)(11)(12) .…”

Section: Introductionmentioning

confidence: 99%

“…Several studies using different methods have recently been reported about sonographic examination of the different airway structures so as to ascertain the placement of LMA (4,5,11) . However, there is no consensus on which method is more effective.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The Evaluation of Different Ultrasonography Techniques for Confirmation of Laryngeal Mask Airway (LMA) Placement in Pediatric Patients

Tosun¹,

Kılıçarslan²,

Gök³

et al. 2020

jarss

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Objective: It is likely that laryngeal mask airway (LMA) is frequently misplaced because of the anatomical differences in children's airways. Our aim is to assess the feasibility of different ultrasonography (USG) techniques for the confirmation of the accurate placement of LMA in pediatric population. Method: After a local ethics committee approval and written informed consents were obtained, 50 children aged 1-12 years were consecutively included into this prospective, observational study. After the anesthetic induction, the position of LMA was evaluated by clinical tests and realtime upper airway USG in three planes (at the level of tongue base, the larynx and upper end of the esophagus). The symmetry of the cuff shadows at the tongue base and arytenoid cartilages was assessed by USG (arytenoid grade). The presence of cuff tip in the esophagus and the shape of the cuff (regular or distorted) was recorded. Fiberoptic bronchoscopy (FOB) was performed to confirm the position of LMA (FOB grade). The Spearman correlation coefficient and Fisher's exact tests were used to test the relationship between FOB and sonographic parameters. Results: The rate of accurate LMA placement through clinical tests was determined as 82% at the first attempt. The rate of recognizing the glottic opening was also found as 74% with FOB. The result showed a statistically significant association between the asymmetry of cuff shadow at the tongue base and FOB LMA grade (Fisher's exact test, p<0.001). The correlation was also statistically significant between FOB grade and USG arytenoid grade (r=0.672, p<0.001). Conclusion: USG can be used to identify the accurate placement and repositioning of LMA as a non-invasive, rapid and reliable method not requiring interruption of the ventilation. Further detailed studies are required to compare the different USG techniques for the confirmation of correct placement of LMA.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Evaluation of Different Ultrasonography Techniques for Confirmation of Laryngeal Mask Airway (LMA) Placement in Pediatric Patients

Tosun¹,

Kılıçarslan²,

Gök³

et al. 2020

jarss

View full text Add to dashboard Cite

show abstract

“…[73][74][75] Airway ultrasound is useful in various areas of RTs' involvement in airway management, including confirmation of endotracheal tube placement, 75,76 prediction of difficult intubation, 77 prediction of pediatric endotracheal tube size and placement, 78,79 detection of subglottic stenosis, 80 prediction of postextubation stridor, 81 and confirmation of laryngeal mask airway position. 82 Ultrasound confirmation of endotracheal intubation is achieved by keeping the transducer at the level of the suprasternal notch in the transverse approach, where the shadow of the endotracheal tube is seen as semicircular hyperechoic lines in the trachea with an empty esophagus (Fig. 12).…”

Section: Airway Managementmentioning

confidence: 99%

Lung Ultrasound: The Emerging Role of Respiratory Therapists

et al. 2019

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Lung ultrasound is a point-of-care imaging tool that is routinely used in acute care medicine. Traditionally, radiology physicians were the primary practitioners of diagnostic ultrasound, but with the recognition of its importance in intensive care medicine, critical care physicians have also adopted this practice. Within the intensive care unit inter-professional team is the respiratory therapist, who participates actively in the care of ventilated patients. Their scope of responsibility is expanding with newer technologies being brought into clinical use on a regular basis. This review focuses on the scope and benefits of ultrasound training within respiratory care-related areas.

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Comparison of Ultrasound Examination and Fiberoptic Laryngoscopy for Confirmation of Laryngeal Mask Airway Placement

Malik

Arora

Kakkar

et al. 2023

J of Ultrasound Medicine

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Objectives 1) To compare ultrasound (US) examination and fiberoptic laryngoscopy (FOL) for confirmation of laryngeal mask airway (LMA) placement. 2) To evaluate the necessity for reinsertion of LMA based on FOL. Methods This prospective observational study included 100 adult patients of American Society of Anesthesiologists (ASA) Grade I and II, undergoing elective surgery under General Anesthesia requiring Proseal LMA™ placement as an airway device. LMA placement was first confirmed by clinical tests. Clinically acceptable patients were further assessed by US and categorized as acceptable (US‐A) or unacceptable (US‐U) and again by FOL as (FOL‐A and FOL‐U). Categorical variables presented in number, percentage (%), and continuous variables presented as mean ± SD and median. Inter‐rater kappa agreement was used to find out the strength of agreement of acceptability between FOL and US. Results The LMA placement was clinically acceptable in 82% of patients on first attempt. FOL had 63% (FOL‐A) acceptable LMA placement as compared with US examination which had 56% (US‐A). In 85% of patients, US and FOL findings were in good agreement with each other for LMA placement (κ = 0.690 and P < .05). In all patients of FOL of unacceptable (FOL‐U) category (37%), LMA was replaced with endotracheal tube. Conclusion US provides a safe, non‐invasive, and real‐time dynamic assessment with 85% diagnostic accuracy for confirmation of LMA placement as compared with FOL.

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Confirmation of laryngeal mask airway placement by ultrasound examination: a pilot study

Cited by 33 publications

References 14 publications

The Evaluation of Different Ultrasonography Techniques for Confirmation of Laryngeal Mask Airway (LMA) Placement in Pediatric Patients

The Evaluation of Different Ultrasonography Techniques for Confirmation of Laryngeal Mask Airway (LMA) Placement in Pediatric Patients

Lung Ultrasound: The Emerging Role of Respiratory Therapists

Comparison of Ultrasound Examination and Fiberoptic Laryngoscopy for Confirmation of Laryngeal Mask Airway Placement

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