The design of the perfect pediatric supraglottic airway device

Huang, Andrea; Sarver, Ashley; Widing, Amanda; Hajduk, John; Jagannathan, Narasimhan

doi:10.1111/pan.13785

Cited by 7 publications

(6 citation statements)

References 31 publications

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“…Pediatric SGAs have significantly improved in recent years. 271 Fewer adverse respiratory events have been described with SGA use for infant airway management compared with tracheal intubation. Neonatal resuscitation with SGAs can result in fewer neonatal intensive care unit admissions and superior resuscitation rates compared with FMV and tracheal intubation.…”

Section: The Pediatric Patient—special Considerationsmentioning

confidence: 99%

Canadian Airway Focus Group updated consensus-based recommendations for management of the difficult airway: part 1. Difficult airway management encountered in an unconscious patient

Law

Duggan

Asselin

et al. 2021

Can J Anesth/J Can Anesth

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Purpose Since the last Canadian Airway Focus Group (CAFG) guidelines were published in 2013, the literature on airway management has expanded substantially. The CAFG therefore re-convened to examine this literature and update practice recommendations. This first of two articles addresses difficulty encountered with airway management in an unconscious patient. Source Canadian Airway Focus Group members, including anesthesia, emergency medicine, and critical care physicians, were assigned topics to search. Searches were run in the Medline, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL databases. Results were presented to the group and discussed during video conferences every two weeks from April 2018 to July 2020. These CAFG recommendations are based on the best available published evidence. Where high-quality evidence was lacking, statements are based on group consensus. Findings and key recommendations Most studies comparing video laryngoscopy (VL) with direct laryngoscopy indicate a higher first attempt and overall success rate with VL, and lower complication rates. Thus, resources allowing, the CAFG now recommends use of VL with appropriately selected blade type to facilitate all tracheal intubations. If a first attempt at tracheal intubation or supraglottic airway (SGA) placement is unsuccessful, further attempts can be made as long as patient ventilation and oxygenation is maintained. Nevertheless, total attempts should be limited (to three or fewer) before declaring failure and pausing to consider “exit strategy” options. For failed intubation, exit strategy options in the still-oxygenated patient include awakening (if feasible), temporizing with an SGA, a single further attempt at tracheal intubation using a different technique, or front-of-neck airway access (FONA). Failure of tracheal intubation, face-mask ventilation, and SGA ventilation together with current or imminent hypoxemia defines a “cannot ventilate, cannot oxygenate” emergency. Neuromuscular blockade should be confirmed or established, and a single final attempt at face-mask ventilation, SGA placement, or tracheal intubation with hyper-angulated blade VL can be made, if it had not already been attempted. If ventilation remains impossible, emergency FONA should occur without delay using a scalpel-bougie-tube technique (in the adult patient). The CAFG recommends all institutions designate an individual as “airway lead” to help institute difficult airway protocols, ensure adequate training and equipment, and help with airway-related quality reviews.

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Section: The Pediatric Patient—special Considerationsmentioning

confidence: 99%

Canadian Airway Focus Group updated consensus-based recommendations for management of the difficult airway: part 1. Difficult airway management encountered in an unconscious patient

Law

Duggan

Asselin

et al. 2021

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

show abstract

“…The supraglottic airway (SGA) is a well-established airway management strategy and plays a safe and important role in pediatric anesthesia. 7 The goal of supraglottic device placement is to create a perilaryngeal seal through which ventilation can occur. 7 These devices can be electively used when tracheal intubation is not necessary.…”

Section: Supraglottic Airwaysmentioning

confidence: 99%

“…7 The goal of supraglottic device placement is to create a perilaryngeal seal through which ventilation can occur. 7 These devices can be electively used when tracheal intubation is not necessary. 7 SGA use can also serve as a rescue device in cases of unexpected difficult airway (e.g., difficult ventilation and failure to intubate) and emergency airway management.…”

Section: Supraglottic Airwaysmentioning

confidence: 99%

“…7 These devices can be electively used when tracheal intubation is not necessary. 7 SGA use can also serve as a rescue device in cases of unexpected difficult airway (e.g., difficult ventilation and failure to intubate) and emergency airway management. 7 SGA use in the pediatric population yields lower failure rates than in the adult population (0.86% vs 1.1%); therefore, its use is often an acceptable and safe airway option for both manual and assisted ventilation.…”

Section: Supraglottic Airwaysmentioning

confidence: 99%

“…7 SGA use can also serve as a rescue device in cases of unexpected difficult airway (e.g., difficult ventilation and failure to intubate) and emergency airway management. 7 SGA use in the pediatric population yields lower failure rates than in the adult population (0.86% vs 1.1%); therefore, its use is often an acceptable and safe airway option for both manual and assisted ventilation. 8 SGAs are safe and effective and, depending on surgical requirements, may be preferable to intubation, particularly for infants and small children.…”

Section: Supraglottic Airwaysmentioning

confidence: 99%

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