Ease of ventilation through the cuffed oropharyngeal airway (COPA), the laryngeal mask airway and the face mask in a cardiopulmonary resuscitation training manikin

Resuscitation ◽  
2001 ◽  
Vol 50 (2) ◽  
pp. 173-177 ◽  
Author(s):  
Roser Garcia-Guasch ◽  
Miquel Ferrà ◽  
Pere Benito ◽  
Jordi Oltra ◽  
Josep Roca
Keyword(s):  
Laryngeal Mask Airway ◽  
Cardiopulmonary Resuscitation ◽  
Face Mask ◽  
Laryngeal Mask ◽  
Oropharyngeal Airway ◽  
Resuscitation Training ◽  
The Face

Pharyngolaryngeal, Neck, and Jaw Discomfort after Anesthesia with the Face Mask and Laryngeal Mask Airway at High and Low Cuff Volumes in Males and Females

2000 ◽  
Vol 93 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Joseph Brimacombe ◽  
Lindsey Holyoake ◽  
Christian Keller ◽  
Nick Brimacombe ◽  
Miriam Scully ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Sore Throat ◽  
Face Mask ◽  
Laryngeal Mask ◽  
High Group ◽  
Relative Incidence ◽  
Surgical Pain ◽  
Inflated Cuff ◽  
The Face ◽  
Males And Females

Background There is controversy over (1) the relative incidence of sore throat between the face mask (FM) and laryngeal mask airway (LMA), (2) the efficacy of LMA intracuff pressure reduction as a mechanism for minimizing sore throat, and (3) the relative incidence of sore throat with the LMA between males and females. In a randomized double-blind study, the authors compared laryngopharyngeal, neck, and jaw discomfort with the FM and LMA at high and low cuff volumes in males and females. Methods Three hundred adult patients were randomly assigned to three equal-sized groups for airway management: (1) the FM, (2) the LMA with a fully inflated cuff (LMA-High), or (3) the LMA with a semi-inflated cuff (LMA-Low). Anesthesia was administered with propofol, nitrous oxide, oxygen, and isoflurane. In the FM group, a Guedel-type oropharyngeal airway and jaw thrust were used only if necessary. In the LMA groups, cuff inflation was achieved with either 15 or 30 ml for the size 4 (females) and 20 or 40 ml for the size 5 (males). The LMA was removed when the patient was awake. Patients were questioned 18-24 h postoperatively about surgical pain, sore throat, sore neck, sore jaw, dysphonia, and dysphagia, and about whether they were satisfied with their anesthetic. Results The incidence of sore throat was lower in the FM (8%) than the LMA-High (42%) and LMA-Low (20%) groups (both: P < or = 0.02). The incidence of sore neck was higher for the FM (14%) than the LMA-High group (6%; P = 0.05) but similar to the LMA-Low group (8%). The incidence of sore jaw was higher in the FM (11%) than the LMA-High (3%) and LMA-Low (3%) groups (both: P = 0. 02). There were no differences among groups for surgical pain or dysphonia. The incidence of dysphagia was lower in the FM (1%) than the LMA-High group (11%; P = 0.003), but similar to the LMA-Low group (1%). The incidence of sore throat and dysphagia was lower in the LMA-Low group than the LMA-High group for both males and females (all: P < or = 0.04). There were no differences in discomfort levels between males and females in any group. Two patients from the FM group and one from the LMA-High group were not satisfied with their anesthetic. These complaints were unrelated to postoperative morbidity. Conclusion The LMA causes more sore throat and dysphagia but less jaw pain than the FM. Sore throat and dysphagia are more common with the LMA if the initial cuff volume is high. There are no differences in discomfort levels between males and females. However, these discomforts do not influence patient satisfaction after LMA or FM anesthesia.

Supreme Laryngeal Mask Airway versus Face Mask during Neonatal Resuscitation: A Randomized Controlled Trial

2015 ◽  
Vol 167 (2) ◽  
pp. 286-291.e1 ◽  
Author(s):  
Daniele Trevisanuto ◽  
Francesco Cavallin ◽  
Loi Ngoc Nguyen ◽  
Tien Viet Nguyen ◽  
Linh Dieu Tran ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Laryngeal Mask Airway ◽  
Controlled Trial ◽  
Neonatal Resuscitation ◽  
Face Mask ◽  
Laryngeal Mask ◽  
Randomized Controlled

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.

scholarly journals Gastric rupture associated with use of the laryngeal mask airway during cardiopulmonary resuscitation

BMJ ◽  
2004 ◽  
Vol 329 (7476) ◽  
pp. 1225-1226 ◽  
Author(s):  
Nathaniel Haslam ◽  
G Claire Campbell ◽  
John E Duggan
Keyword(s):  
Laryngeal Mask Airway ◽  
Cardiopulmonary Resuscitation ◽  
Laryngeal Mask ◽  
Gastric Rupture

scholarly journals Ventilating the Bearded: A Randomized Crossover Trial Comparing a Novel Bag-Valve-Guedel Adaptor to a Standard Mask

2019 ◽  
Vol 185 (7-8) ◽  
pp. e1300-e1308
Author(s):  
Lilach Gavish ◽  
Mor Rittblat ◽  
S David Gertz ◽  
Ruth Shaylor ◽  
Charles Weissman ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Armed Forces ◽  
Face Mask ◽  
Airway Device ◽  
Technical Solution ◽  
Success Rates ◽  
Oropharyngeal Airway ◽  
The Face ◽  
Common Face ◽  
End Tidal

Abstract Introduction: Emergency field ventilation using bag-valve face mask devices can be difficult to perform, especially in bearded individuals. In view of the increasing numbers of servicemen and civilians sporting a beard or moustache, the issue of finding a technical solution for ventilation in this population has gained importance. We therefore developed a novel adaptor that enables the direct connection of a bag-valve device to a Guedel-type oropharyngeal airway device thereby directly connecting the oral airway to the bag valve, eliminating the need for a face mask. The objective of this study was to compare the efficacy of the bag-valve-Guedel adaptor (BVGA) to the common face mask in healthy bearded volunteers. Methods: This study was a randomized-by-sequence, crossover-controlled trial (NCT02768246) approved by the local IRB (0051-16-HMO). All subjects signed an informed consent before participation. Twenty-five healthy bearded men (age 28 ± 7) were recruited. After randomization, the first group (mask then BVGA, n = 12) began breathing room air through the face mask, followed by 100% O2. After washout in room air, the procedure was repeated with the BVGA. The second group (BVGA then mask, n = 13) began with the BVGA followed by the face mask. Subjects were awake and breathed spontaneously throughout the experiment. Therefore, a Guedel was not used. Physiological and respiratory parameters were monitored continuously. The primary endpoint was the presence of suspected leak as determined by end-tidal-CO2 (EtCO2 < 20 mmHg). Secondary endpoints included tidal volume and safety. Results: The order of device use did not affect the results significantly (p > 0.05 by Mann-Whitney-U test); therefore, the data were pooled. There were no cases of suspected leak while breathing through the BVGA. By contrast, while breathing through a face mask, there were 8 of 25 (32%) and 5 of 25 (20%) cases of suspected leak in air and 100% O2, respectively (air: p = 0.002; 100% O2: p = 0.014 by McNemar test). No adverse events were observed. Conclusions: In bearded individuals, the BVGA provides significantly more efficient (less leak) ventilation compared to a face mask. This is also of particular importance in view of the increasing number of bearded individuals serving in the armed forces. Moreover, since effective ventilation with a mask requires experience, the relatively easy-to-apply BVGA will enable less experienced first responders to achieve higher success rates in this critical phase of treatment. Further studies are planned to evaluate the efficacy of the BVGA in the prehospital setting.

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