scholarly journals Air humidification might help to prevent irritation and damage to the vocal cords during intermittent positive pressure ventilation using a laryngeal mask airway

2006 ◽  
Vol 53 (2) ◽  
pp. 211-212 ◽  
Author(s):  
Joaquin Fabregat ◽  
Cristina Arce ◽  
Thomas M. Hemmerling
Keyword(s):  
Laryngeal Mask Airway ◽  
Positive Pressure Ventilation ◽  
Intermittent Positive Pressure Ventilation ◽  
Laryngeal Mask ◽  
Positive Pressure ◽  
Vocal Cords ◽  
Air Humidification

Resuscitation of Neonates with the Laryngeal Mask Airway—A Caution

PEDIATRICS ◽  
1995 ◽  
Vol 95 (3) ◽  
pp. 453-454
Author(s):  
Joe Brimacombe ◽  
D. Gandini
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Pressure ◽  
Positive Pressure Ventilation ◽  
Positive Airway Pressure ◽  
Neonatal Resuscitation ◽  
Standard Technique ◽  
Intermittent Positive Pressure Ventilation ◽  
Laryngeal Mask ◽  
Positive Pressure ◽  
Meconium Aspiration

We would like to report our experience with the laryngeal mask airway (LMA) for neonatal resuscitation. The LMA was used in neonates with apnea or heart rate <100 min-1 who had no evidence of meconium aspiration. The LMA was inserted using the standard technique with the cuff fully deflated and then inflated with 2 to 5 mL air.1 It was then held in place manually and connected to a pediatric Mapleson F circuit. Intermittent positive-pressure ventilation or continuous positive airway pressure was administered until respiration was established.

The Laryngeal Mask Airway and Positive-pressure Ventilation

1994 ◽  
Vol 80 (3) ◽  
pp. 550-555 ◽  
Author(s):  
J. Hugh Devitt ◽  
Richard Wenstone ◽  
Alva G. Noel ◽  
Michael P. O'Donnell
Keyword(s):  
Laryngeal Mask Airway ◽  
Positive Pressure Ventilation ◽  
Laryngeal Mask ◽  
Positive Pressure

Effects of nasal positive-pressure hyperventilation on the glottis in normal awake subjects

1995 ◽  
Vol 79 (1) ◽  
pp. 176-185 ◽  
Author(s):  
V. Jounieaux ◽  
G. Aubert ◽  
M. Dury ◽  
P. Delguste ◽  
D. O. Rodenstein
Keyword(s):  
Tidal Volume ◽  
Positive Pressure Ventilation ◽  
Anterior Commissure ◽  
Minute Ventilation ◽  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Vocal Cords ◽  
Diaphragmatic Muscle ◽  
Inspiratory Resistance ◽  
Cyclic Changes

We have recently observed obstructive apneas during nasal intermittent positive-pressure ventilation (nIPPV) and suggested that they were due to hypocapnia-induced glottic closure. To confirm this hypothesis, we studied seven healthy subjects and submitted them to nIPPV while their glottis was continuously monitored through a fiber-optic bronchoscope. During wakefulness, we measured breath by breath the widest inspiratory angle formed by the vocal cords at the anterior commissure along with several other indexes. Mechanical ventilation was progressively increased up to 30 l/min. In the absence of diaphragmatic activity, increases in delivered minute ventilation resulted in progressive narrowing of the vocal cords, with an increase in inspiratory resistance and a progressive reduction in the percentage of the delivered tidal volume effectively reaching the lungs. Adding CO2 to the inspired gas led to partial widening of the glottis in two of three subjects. Moreover, activation of the diaphragmatic muscle was always associated with a significant inspiratory abduction of the vocal cords. Sporadically, complete adduction of the vocal cords was directly responsible for obstructive laryngeal apneas and cyclic changes in the glottic aperture resulted in waxing and waning of tidal volume. We conclude that in awake humans passive ventilation with nIPPV results in vocal cord adduction that depends partly on hypocapnia, but our results suggest that other factors may also influence glottic width.

Abstract 59: The Incidence Of Pulmonary Aspiration With Laryngeal Mask Airway Use During Cardiopulmonary Resuscitation And Positive Pressure Ventilation In Swine.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Brian Suffoletto ◽  
James Menegazzi ◽  
Eric Logue ◽  
David Salcido
Keyword(s):  
Laryngeal Mask Airway ◽  
Cardiopulmonary Resuscitation ◽  
Positive Pressure Ventilation ◽  
Validation Cohort ◽  
Pulmonary Aspiration ◽  
Laryngeal Mask ◽  
Positive Pressure ◽  
Suction Catheter ◽  
Chest Compressions ◽  
Lung Expansion

Objective: Pulmonary aspiration of gastric contents occurs 20 –30% of the time during cardiopulmonary resuscitation (CPR) of cardiac arrest. This is due to loss of protective airway reflexes, pressure changes generated during CPR, and positive pressure ventilation (PPV). Even though the American Heart Association (AHA) has recommended the laryngeal mask airway (LMA) as an acceptable alternative airway for use by EMS personnel, concerns over the capacity of the device to protect from pulmonary aspiration remain. We sought to determine the incidence of aspiration after LMA placement, CPR and PPV. Methods: We conducted a prospective study on 16 consecutive post-experimental mixed-breed domestic swine of either sex (mean mass 25.7 ±1.4 kgs). A standard size-4 LMA was modified so that a vacuum catheter could be advanced into and past the LMA diaphragm. The LMA was placed into the hypopharynx and its position confirmed using End-tidal CO 2 and direct visualization of lung expansion. Fifteen milliliters of heparinized blood were instilled into the pharynx. After 5 PPVs with a mechanical ventilator, chest compressions were performed for 60s with asynchronous ventilations continuing at a rate of 12 per minute. After chest compressions, a suction catheter was inserted through the cuff and suction applied for approximately 1 minute. The catheter was removed and inspected for signs of blood. The LMA cuff was deflated and the LMA removed. The intima of the LMA diaphragm was inspected for signs of blood. In a validation cohort of 4 animals, the LMA was reinserted, a cricothyrotomy performed and 5 mL of blood instilled directly into the trachea. Results: There were 0/16 (95% CI=0 –17%) with a positive tests for the presence of blood in both the vacuum catheter and the intima of the LMA diaphragm. In the validation cohort, all four were positive for blood in both the vacuum catheter and the intima of the LMA diaphragm. Conclusions: In this simple model of regurgitation of after LMA placement, there was no sign of pulmonary aspiration, and no evidence that blood had passed beyond the seal created by the LMA cuff. Concerns over aspiration with LMA use may be unfounded. Future studies should determine the frequency of pulmonary aspiration after LMA placement in the clinical setting.

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