Document Detail

A comparison of seal in seven supraglottic airway devices using a cadaver model of elevated esophageal pressure.
MedLine Citation:
PMID:  18227299     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Supraglottic airway devices are increasingly important in clinical anesthesia and prehospital emergency medicine, but there are only few data to assess the risk for aspiration. We designed this study to compare the seal of seven supraglottic airway devices in a cadaver model of elevated esophageal pressure. METHODS: The classic laryngeal mask airway, laryngeal mask airway ProSeal, intubating laryngeal mask airway Fastrach, laryngeal tube, laryngeal tube LTS II, Combitube, and Easytube were inserted into unfixed human cadavers with an exposed esophagus that had been connected to a water column of 130 cm height. Slow and fast increases of esophageal pressure were performed and the water pressure at which leakage appeared was registered. RESULTS: The Combitube, Easytube, and intubating laryngeal mask Fastrach withstood the water pressure up to more than 120 cm H2O. The laryngeal mask airway ProSeal, laryngeal tube, and laryngeal tube LTS II were able to block the esophagus until 72-82 cm H2O. The classic laryngeal mask airway showed leakage at 48 cm H2O, but only minor leakage was found in the trachea. Devices with an additional esophageal drain tube drained fluid sufficiently without pulmonary aspiration. CONCLUSIONS: Concerning the risk of aspiration, the use of devices with an additional esophageal drainage lumen might be superior for use in patients with an increased risk of aspiration. The Combitube, Easytube, and intubating laryngeal mask Fastrach showed the best capacity to withstand an increase of esophageal pressure.
Sven Bercker; Willi Schmidbauer; Thomas Volk; Gottfried Bogusch; Hans Peter Bubser; Mario Hensel; Thoralf Kerner
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  106     ISSN:  1526-7598     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-01-29     Completed Date:  2008-02-19     Revised Date:  2008-08-21    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  445-8, table of contents     Citation Subset:  AIM; IM    
Department of Anesthesiology and Intensive Care Medicine, Leipzig University Hospital, Germany.
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MeSH Terms
Aged, 80 and over
Air Pressure
Disposable Equipment / standards
Equipment Design / standards
Esophagus / physiology*
Glottis / physiology
Intubation, Intratracheal / instrumentation*,  standards*
Laryngeal Masks / standards*
Middle Aged
Comment In:
Anesth Analg. 2008 Jul;107(1):344-5; author reply 345   [PMID:  18635510 ]

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

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