scholarly journals Unusual pericuff leak around proseal-laryngeal mask airway corrected by clamping gastric drain port: A case report

2021 ◽  
pp. 345-347
Author(s):  
Mohd. Mustahsin ◽  
Debesh Bhoi
Keyword(s):  
Mechanical Ventilation ◽  
Laryngeal Mask Airway ◽  
Laryngeal Mask ◽  
Drain Tube ◽  
Air Leak ◽  
Successful Management ◽  
Air Leaks ◽  
Gastric Contents ◽  
Controlled Mechanical Ventilation ◽  
Ryle’S Tube

ProSealTM-Laryngeal Mask Airway (PLMA) (Laryngeal Mask Company, Henley-on Thames, UK) is commonly used for securing the airway with an added advantage over classic LMA as its gastric drain tube allows the insertion of Ryle’s tube and suctioning of gastric contents. The ProSeal LMA is designed in such a way that it allows controlled mechanical ventilation. During controlled mechanical ventilation, air leaks can occur because of positive airway pressures. Air leaks from the gastric drain port are almost always due to the malposition of PLMA. Here, we report a case of air leak from gastric drain port despite correctly placed PLMA and its successful management without removing the device.

scholarly journals Feasibility, Accuracy and Optimal Location for Oesophageal Core Temperature Measurements Using the ProSeal Laryngeal Mask Airway Drain Tube

2003 ◽  
Vol 31 (3) ◽  
pp. 282-285 ◽  
Author(s):  
S. Mitchell ◽  
J. Brimacombe ◽  
C. Keller
Keyword(s):  
Laryngeal Mask Airway ◽  
Temperature Measurement ◽  
Core Temperature ◽  
Optimal Location ◽  
Proseal Laryngeal Mask Airway ◽  
Laryngeal Mask ◽  
Temperature Measurements ◽  
Drain Tube ◽  
Oesophageal Temperature ◽  
Temperature Probe

We determined the feasibility, accuracy and optimal location of oesophageal core temperature measurements using the ProSeal laryngeal mask airway drain tube. Thirty normothermic anaesthetized ventilated adults (ASA 1 to 2, aged 18 to 80 years) were studied. Temperatures were recorded using a thermistor at six different locations (middle of drain tube and at 0 to 20 cm distal to the drain tube in 5 cm increments) and compared to nasopharyngeal (thermistor) and aural (infrared tympanic thermometer) reference core temperatures. The temperature probe was successfully inserted into the oesophagus in all patients at the first attempt. Oesophageal temperature increased with depth from 0 to 5 cm (35.2 v 35.9, P<0.0001) and 5 to 10 cm (35.9 v 36.3, P<0.01), but was unchanged from 10 to 15 cm (36.3 v 36.6) and 15 to 20 cm (36.6 v 36.7). Aural temperature was higher than nasopharyngeal temperature (36.8 v 36.0, P<0.0001). Aural temperature was 0.89 to 1.59°C higher than the oesophagus at 0 to 5 cm and 0.21 to 0.30°C higher than the oesophagus at 15 to 20 cm. Nasopharyngeal temperature was 0.06 to 0.76°C higher than the oesophagus at 0 to 5 cm and 0.62 to 0.84°C lower than the oesophagus at 15 to 20 cm. The lowest temperature was in the mid-point of the drain tube (34.7). We conclude that oesophageal core temperature measurement is feasible and accurate using the ProSeal laryngeal mask airway. The optimal location for the temperature probe is at 15 to 20 cm.

Laryngeal Mask Airway for Surfactant Administration Versus Standard Treatment Methods in Preterm Neonates with Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Roqaia Ayesh Al Ali ◽  
Bishal Gautam ◽  
Michael R. Miller ◽  
Sherry Coulson ◽  
Doris Yuen
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Laryngeal Mask Airway ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Risk Ratio ◽  
Distress Syndrome ◽  
Meta Analysis ◽  
Mean Difference ◽  
Laryngeal Mask

Objective Laryngeal mask airway (LMA) has emerged as an alternative surfactant delivery method. The effectiveness of this method for the delivery of surfactant is uncertain. A meta-analysis of randomized control trials (RCTs) comparing LMA with standard methods of surfactant delivery for the outcomes of surfactant dose repetition, oxygen requirement, mechanical ventilation, intubation, mortality, bronchopulmonary dysplasia (BPD), and pneumothorax. Study Design Systematic review and meta-analysis of RCTs. Homogeneity between studies was analyzed by using I2 statistics. Risk ratio or mean difference of outcomes was assessed from random effects models. Subgroup analyses were conducted when necessary. Data sources are as follows: Ovid Medline, Embase, and the Cochrane Central Register of Controlled trials from inception till December 2018, bibliographies of identified reviews and trial registries for ongoing studies. RCTs comparing short-term respiratory outcomes in neonates with respiratory distress syndrome who were administered surfactant through an LMA versus standard method of care. Results Six RCTs were identified, enrolling a total of 357 infants. Administering surfactant via LMA was associated with decreased FiO2 requirement (mean difference = 1.82 (95% confidence interval [CI]: −6.01 to 9.66), decreased intubation (risk ratio [RR] = 0.17; 95% CI: 0.05–0.57), and decreased mechanical ventilation (RR = 0.44; 95% CI: 0.31–0.61). There were no significant differences between groups for death, BPD, or pneumothorax. Conclusion LMA might be an effective alternative method of surfactant delivery; however, further high-quality RCTs with larger sample size and including extreme preterm infants are needed to establish LMA as an alternative technique for surfactant delivery. Key Points

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