Gas leakage and the laryngeal mask airway: A comparison with the tracheal tube and facemask during spontaneous ventilation using a circle breathing system

Abstract

SummaryThe ability of'the laryngeal mask airway, tracheal tube und facemask to provide a leak free seal in a clinical setting was assessed by measuring the minimal fresh gas flows needed in a closed circle system during spontaneous oentilation on 60 subjects. The ,fresh gas.flow was reduced until no spillage occurred,from the pop-of valve. This,fresh gas flow was taken to represent the sum of gas uptuke by the subject and gas leakage from the circuit.

Minimal-flow anaesthesia with controlled ventilation: comparison between laryngeal mask airway and endotracheal tube

“…The safety and efficiency of the laryngeal mask airway have already been demonstrated in large clinical studies [13]. Although the laryngeal mask airway is known to form an airtight seal in patients during spontaneous ventilation [5], which allows reduction of the fresh gas flow to 0.5 L min −1 , prospective studies to evaluate the feasibility of fresh gas flow reduction during controlled mechanical ventilation of the lungs with the use of the laryngeal mask airway have not been performed. This is of particular interest as leakage may occur due to increased inspiratory pressures during positive‐pressure ventilation.…”

“…The endotracheal tube has been shown to form an airtight seal between the anaesthesia circle system and the patient’s airway, and allows routine reduction of fresh gas flow down to 0.5 L min −1 . Although clinical studies assessed the possibility of fresh gas flow reduction when using laryngeal mask airway in spontaneously breathing patients [5], it has not been shown that the laryngeal mask airway permits low‐ or minimal‐flow anaesthetic methods during controlled ventilation. This study shows that the laryngeal mask airway can be used during controlled ventilation using a fresh gas flow of 0.5 L min −1 .…”

“…The laryngeal mask airway is an established method of airway control. Although several clinical studies assessed the possibility of fresh gas flow reduction when using the laryngeal mask airway in spontaneously breathing patients [5], it has not been shown that the laryngeal mask airway allows low‐ or minimal‐flow anaesthetic methods during controlled ventilation of the lungs.…”

Gender difference in mask ventilation training of anesthesia residents

“…Therefore, training in mask ventilation is essential for all residents. Previous studies have reported operator difficulty in attaining and holding a proper air seal [13][14][15]. Langeron et al and Clayton et al each reported that gas leakage was an important issue during difficult mask ventilation [4,16].…”

Comparison of postoperative complication between Laryngeal Mask Airway and endotracheal tube during low-flow anesthesia with controlled ventilation

“…5 - 7 Although the LMA does not provide a watertight seal, it has been used largely during positive pressure ventilation in adults and children. 8 , 9 Some studies support the concept of safety of using LMA during low-flow anesthesia.…”