| Guided insertion of the ProSeal laryngeal mask airway is superior to conventional tracheal intubation by first-month anesthesia residents after brief manikin-only training. | |
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MedLine Citation:
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PMID: 16861434 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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In the following pilot study, we compared conventional laryngoscope-guided tracheal intubation (tracheal intubation) and laryngoscope-guided, gum elastic bougie-guided ProSeal laryngeal mask airway insertion (guided ProSeal) for airway management by first-month anesthesia residents after brief manikin-only training. Five first-month residents with no practical experience of airway management were observed performing these techniques in 200 ASA I-II anesthetized, paralyzed adults. Each resident managed 40 patients, 20 in each group, in random order. The number of insertion attempts, effective airway time, ventilatory capability during pressure-controlled ventilation set at 15 cm H2O, airway trauma, and skill acquisition were studied. Data were collected by unblinded observers. Insertion was more frequently successful (100% versus 65%) and effective airway time was shorter (41 +/- 24 s versus 89 +/- 62 s) in the guided ProSeal group (both P < 0.0001). Expired tidal volume was larger (730 +/- 170 mL versus 560 +/- 140 mL) and end-tidal CO(2) lower (33 +/- 4 mm Hg versus 37 +/- 5 mm Hg) in the guided ProSeal group during pressure controlled ventilation (both P < 0.0001). Blood staining was more frequent on the laryngoscope (24% versus 2%; P < 0.0001) in the tracheal intubation group. There was evidence for skill acquisition in both groups. We conclude that laryngoscope-guided, gum elastic bougie-guided insertion of the ProSeal laryngeal mask airway is superior to conventional laryngoscope-guided tracheal intubation for airway management in terms of insertion success, expired tidal volume, and airway trauma by first-month anesthesia residents after brief manikin-only training. The guided ProSeal technique has potential for cardiopulmonary resuscitation by novices when conventional intubation fails. |
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Authors:
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Matthias Hohlrieder; Joseph Brimacombe; Achim von Goedecke; Christian Keller |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 103 ISSN: 1526-7598 ISO Abbreviation: Anesth. Analg. Publication Date: 2006 Aug |
Date Detail:
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Created Date: 2006-07-24 Completed Date: 2006-08-09 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: United States |
Other Details:
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Languages: eng Pagination: 458-62, table of contents Citation Subset: AIM; IM |
Affiliation:
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Department of Anaesthesia and Intensive Care Medicine, Medical University Innsbruck, Austria. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Aged Anesthesiology / education* Humans Internship and Residency* Intubation, Intratracheal / adverse effects, methods* Laryngeal Masks* / adverse effects Laryngoscopy Middle Aged Pilot Projects |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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