Performance of intubation with 4 different airway devices by unskilled rescuers: manikin study

Comparison of the i-gel and other supraglottic airways in adult manikin studies

“…[1,4,11,13,14,21–29] All studies were randomized crossover trials except 1 with parallel design. [21] The included articles contained several comparisons between the i-gel and other supraglottic airways as follows: 4 comparisons with the LMA Classic (LMA North America, Inc., San Diego, USA), [11,22,25,29] 5 with the LMA Fastrach (Laryngeal Mask, Prodol Meditec, Spain), [13,14,24,27,28] 3 with the LMA Proseal (LMA North America, Inc., San Diego, USA), [1,14,23] 3 with the LMA Supreme, [13,23,24] 5 with the LMA Unique (LMA North America, Inc., San Diego, USA), [1,4,14,23,24] 7 with the laryngeal tube (King-LT-D, VBM, Sulz, Germany), [1,4,13,14,21,22,24] 5 with the Combitube (Covidien, Mansfield, MA, USA), [1,4,13,14,24] 4 with the EasyTube (Teleflexmedical Ruesch, Research Triangle Park, NC, USA), [1,4,13,24] 1 with the SoftSeal (Smiths Medical International Ltd, Ashford, Kent, UK), [26] 1 with the AuraOnce (Ambu, Ballerup, Denmark), [26] 1 with the aura-i, [27] and 1 with the air-Q (Cookgas LLC, Mercury Medical, USA). [27] Characteristics of the included articles are summarized in Table 1 .…”

“…[1,13,23,24] Four studies included insertions of devices under difficult circumstances, such as while wearing protective equipment and applying a neck collar and pathologic airway conditions. [14,24,25,29] In this meta-analysis, insertion variables investigated at the second assessment or under difficult circumstances were analyzed additionally. Robak et al's [24] study assessed device insertion under simulated physiologic and pathologic airway conditions at the initial and second assessments.…”

“…Ongoing chest compression during device insertion was applied in 4 studies. [4,26,27,29] However, Ruetzler et al's [4] study allowed transient interruption of chest compression during airway management as required by participants. In Adelborg et al's [26] study, we could not confirm outcomes during concurrent chest compression.…”

A comparison of ProSeal laryngeal mask airway, I-gel and endotracheal tube insertion by novices in a simulated difficult airway scenario

“…The novices in our study showed a success rate of 19.3% for the first attempt and an overall success rate of 56% for ETI in a manikin with restricted cervical spine movement. Lee et al [3] also reported that the success rate for ETI by unskilled rescuers was only 47.4% in a difficult airway scenario. It is difficult to accept such a high failure rate of ETI because unsuccessful tracheal intubation in an emergency situation is associated with high rates of morbidity and mortality [12,13].…”

“…The supraglottic airway devices (SADs) are an alternative to ETI because SADs are technically easier to use than ETI with a conventional Macintosh laryngoscope, as shown by Lee et al [3], who found that with novice operators who were unfamiliar with airway devices, SADs were faster and easier than ETI with a Macintosh laryngoscope in difficult airway scenarios.…”