A comparison of supraglottic devices in pediatric patients

Senthil G Krishna,1,2 Faizaan Syed,1 Mohammed Hakim,1 Mumin Hakim,3 Dmitry Tumin,1 Giorgio C Veneziano,1,2 Joseph D Tobias1,2 1Department of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital, Columbus, OH, USA; 2Department of Anesthesiology & Pain Medicine, The...

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Autores principales:	Krishna SG, Syed F, Hakim M, Tumin D, Veneziano GC, Tobias JD
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Supraglottic airways bronchoscopic view glottic aperture. Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/0fc1238c04c84ab9a5013ec86f51a4db
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spelling	oai:doaj.org-article:0fc1238c04c84ab9a5013ec86f51a4db2021-12-02T02:22:08ZA comparison of supraglottic devices in pediatric patients1179-1470https://doaj.org/article/0fc1238c04c84ab9a5013ec86f51a4db2018-10-01T00:00:00Zhttps://www.dovepress.com/a-comparison-of-supraglottic-devices-in-pediatric-patients-peer-reviewed-article-MDERhttps://doaj.org/toc/1179-1470Senthil G Krishna,1,2 Faizaan Syed,1 Mohammed Hakim,1 Mumin Hakim,3 Dmitry Tumin,1 Giorgio C Veneziano,1,2 Joseph D Tobias1,2 1Department of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital, Columbus, OH, USA; 2Department of Anesthesiology & Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, USA; 3Department of Surgery, Montefiore Medical Centre, Bronx, NY, USA Background: When managing patients with a difficult airway, supraglottic airways (SGAs) have been used as rescue devices or to serve as a conduit for endotracheal intubation. The current study compares various clinical outcomes, including the bronchoscopic view of the glottis when using 2 SGAs, the Air-Q® laryngeal mask airway (LMA) and the i-gel® SGA, in pediatric patients. Methods: Patients ≤18 years of age were prospectively randomized to receive either the Air-Q® LMA or the i-gel® SGA. Following SGA placement, a flexible fiberoptic bronchoscope was inserted through the SGA to visualize the glottis. Time taken to obtain the bronchoscopic view and place the SGA, and the ability to seal the airway at 20 cmH2O were compared. The bronchoscopic view obtained was graded as follows: 1) glottic aperture seen completely; 2) glottic aperture seen partially with visual obstruction <50%; 3) glottic aperture seen, but visual obstruction >50%; and 4) glottic aperture not seen. Results: Fifty patients were enrolled and 48 (22/26 male/female) were included in the analysis. Median age was 13 years (IQR: 7, 16) and median weight was 49 kg (IQR: 25, 70). The Air-Q® LMA and i-gel® SGA groups did not differ in device placement time (median of 19 vs 21 seconds; 95% CI of difference in medians: − 2 to 7; P=0.331), the time to achieve fiberoptic view of the glottis (median of 25 vs 21 seconds; 95% CI of difference: − 9 to 8; P=0.489) or the grade of the bronchoscopic view of the airway. Eight Air-Q® and 6 i-gel® supraglottic devices sealed the airway at 20 cmH2O. Discussion: The time required for successful placement of the SGA, the time required for bronchoscopic view, and the quality of bronchoscopic view through the Air-Q® LMA and the i-gel® SGA did not differ. Keywords: supraglottic airways, bronchoscopic view, glottic apertureKrishna SGSyed FHakim MHakim MTumin DVeneziano GCTobias JDDove Medical PressarticleSupraglottic airwaysbronchoscopic viewglottic aperture.Medical technologyR855-855.5ENMedical Devices: Evidence and Research, Vol Volume 11, Pp 361-365 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Supraglottic airways bronchoscopic view glottic aperture. Medical technology R855-855.5
spellingShingle	Supraglottic airways bronchoscopic view glottic aperture. Medical technology R855-855.5 Krishna SG Syed F Hakim M Hakim M Tumin D Veneziano GC Tobias JD A comparison of supraglottic devices in pediatric patients
description	Senthil G Krishna,1,2 Faizaan Syed,1 Mohammed Hakim,1 Mumin Hakim,3 Dmitry Tumin,1 Giorgio C Veneziano,1,2 Joseph D Tobias1,2 1Department of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital, Columbus, OH, USA; 2Department of Anesthesiology & Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, USA; 3Department of Surgery, Montefiore Medical Centre, Bronx, NY, USA Background: When managing patients with a difficult airway, supraglottic airways (SGAs) have been used as rescue devices or to serve as a conduit for endotracheal intubation. The current study compares various clinical outcomes, including the bronchoscopic view of the glottis when using 2 SGAs, the Air-Q® laryngeal mask airway (LMA) and the i-gel® SGA, in pediatric patients. Methods: Patients ≤18 years of age were prospectively randomized to receive either the Air-Q® LMA or the i-gel® SGA. Following SGA placement, a flexible fiberoptic bronchoscope was inserted through the SGA to visualize the glottis. Time taken to obtain the bronchoscopic view and place the SGA, and the ability to seal the airway at 20 cmH2O were compared. The bronchoscopic view obtained was graded as follows: 1) glottic aperture seen completely; 2) glottic aperture seen partially with visual obstruction <50%; 3) glottic aperture seen, but visual obstruction >50%; and 4) glottic aperture not seen. Results: Fifty patients were enrolled and 48 (22/26 male/female) were included in the analysis. Median age was 13 years (IQR: 7, 16) and median weight was 49 kg (IQR: 25, 70). The Air-Q® LMA and i-gel® SGA groups did not differ in device placement time (median of 19 vs 21 seconds; 95% CI of difference in medians: − 2 to 7; P=0.331), the time to achieve fiberoptic view of the glottis (median of 25 vs 21 seconds; 95% CI of difference: − 9 to 8; P=0.489) or the grade of the bronchoscopic view of the airway. Eight Air-Q® and 6 i-gel® supraglottic devices sealed the airway at 20 cmH2O. Discussion: The time required for successful placement of the SGA, the time required for bronchoscopic view, and the quality of bronchoscopic view through the Air-Q® LMA and the i-gel® SGA did not differ. Keywords: supraglottic airways, bronchoscopic view, glottic aperture
format	article
author	Krishna SG Syed F Hakim M Hakim M Tumin D Veneziano GC Tobias JD
author_facet	Krishna SG Syed F Hakim M Hakim M Tumin D Veneziano GC Tobias JD
author_sort	Krishna SG
title	A comparison of supraglottic devices in pediatric patients
title_short	A comparison of supraglottic devices in pediatric patients
title_full	A comparison of supraglottic devices in pediatric patients
title_fullStr	A comparison of supraglottic devices in pediatric patients
title_full_unstemmed	A comparison of supraglottic devices in pediatric patients
title_sort	comparison of supraglottic devices in pediatric patients
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/0fc1238c04c84ab9a5013ec86f51a4db
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A comparison of supraglottic devices in pediatric patients

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