Document Detail


Respiratory mechanics, gastric insufflation pressure, and air leakage of the laryngeal mask airway.
MedLine Citation:
PMID:  9141925     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A potential risk of the laryngeal mask airway (LMA) is incomplete mask seal, which causes air leakage or insufflation of air into the stomach. The objective of the present study was to assess respiratory mechanics, quantify air leakage, and measure gastric air insufflation in patients ventilated via the LMA. Thirty patients were studied after induction of anesthesia but prior to any surgical manipulations. After the insertion of the LMA, patients were ventilated with increasing tidal volumes until one of the three following end points were reached: 1) gastric air insufflation, 2) airway pressure > 40 cm H2O, or 3) limitation of further increase in tidal volume by air leakage. The following variables were determined:inspired volume (VI), expired volume (VE), maximum inspiratory pressure (Pmax), airway pressure at gastric inflation (Pinfl), respiratory time constant (RC), compliance (C), resistance (R), and leakage fraction (FL). Respiratory mechanics were in the physiological range. Gastric insufflation occurred in 27% of the patients at inspiratory pressures between 19 and 33 cm H2O. Air leakage of more than 10% was evident at inspiratory pressures between 25 and 34 cm H2O. The end point of 40 cm H2O airway pressure was reached in only three patients. We conclude that the LMA is not better in preventing airway pressure transmission to the esophagus than a conventional face mask. However, a high FL is associated with reduced gastric air insufflation.
Authors:
N Weiler; F Latorre; B Eberle; R Goedecke; W Heinrichs
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  84     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  1997 May 
Date Detail:
Created Date:  1997-05-29     Completed Date:  1997-05-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1025-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Anaesthesiology, Johannes Gutenberg University School of Medicine, Mainz, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Female
Humans
Insufflation
Laryngeal Masks* / adverse effects
Male
Middle Aged
Pressure
Respiration, Artificial
Respiratory Mechanics*
Stomach / physiology*
Tidal Volume
Comments/Corrections
Comment In:
Anesth Analg. 1998 Apr;86(4):914-5   [PMID:  9539625 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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