#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Novel supraglottic airway devices in clinical practice


Authors: J. Werner 1;  E. Vobrubová 1;  P. Michálek 1,2
Authors‘ workplace: Klinika anesteziologie, resuscitace a intenzivní medicíny, 1. lékařské fakulta Univerzity Karlovy a Všeobecná fakultní nemocnice v Praze 1;  Department of Anaesthesia, Antrim Area Hospital, Antrim, United Kingdom 2
Published in: Anest. intenziv. Med., 33, 2022, č. 1, s. 19-24
Category: Review Article

Overview

Supraglottic airway devices currently belong to routine clinical practice for securing the airways in elective procedures, but also for tracheal intubation or oxygenation in difficult intubation scenarios. Other indications are airway management in emergency and intensive care medicine or pre-hospital care. Increased safety requirements, extended indications, and use in acute situations have led to the development of novel supraglottic airway devices. Universal devices such as Ambu Aura Gain, LMA Protector, or i-gel Plus allow use in elective surgery and subsequent fiberscope-guided tracheal intubation. Other devices such as the LMA Guardian have been developed in order to increase seal pressures, while the Baska mask has a self-regulating cuff pressure that should theoretically reduce the incidence of postoperative complications. LMA Gastro was developed for endoscopic procedures on the oesophagus and stomach, iLTS, and TotalTrack VLM as special aids for difficult airway management.

Keywords:

supraglotic airway devices – Ambu AuraGain – Baska mask – LMA Protector – LMA Gastro – TotalTrack VLM – i‑gel Plus – iLTS


Sources

1. Michalek P, Miller DM. Airway management evolution – in a search for an ideal extraglottic airway device. Prague Med Rep 2014;115:87-103.

2. Sharma B, Sahai C, Sood J. Extraglottic airway devices: technology update. Med Devices (Auckland) 2017;10:189-205.

3. Klementová O, Henlín T, Szkorupa M, Michálek P. Zajištění dýchacích cest v přednemocniční péči dospělých – to tube or not to tube? Anest intenzív Med 2020;31:6-12.

4. Hunter JM, Aziz MF. Supraglottic airway versus tracheal intubation and the risk of postoperative pulmonary complications. Br J Anaesth 2021;126:P571-P574.

5. Yu SH, Beirne OR. Laryngeal mask airways have a lower risk of airway complications compared with endotracheal intubation: a systematic review. J Oral Maxillofac Surg 2010;68: 2359-2376.

6. Leech Bc. The pharyngeal bulb gasway: a new aid in cyclopropane anaesthesia. Curr Res Anesth Analg 1937;16:22-25.

7. Brain AIJ. The laryngeal mask – a new concept in airway management. Br J Anaesth 1983;55:801-805.

8. Miller DM. A conceptual ideal supraglottic airway. Anest intenzív Med 2011;22.

9. Cook TM, Kelly FE. Time to abandon the ’vintage’ laryngeal mask airway and adopt second‑generation supraglottic airway devices as a first choice. Br J Anaesth 2015;115:497-499.

10. Van Zundert AA, Kumar CM, Van Zundert TC, Gatt SP, Pandit JJ. The case for a 3rd generation supraglottic airway device facilitating direct vision placement. J Clin Monit Comput 2020; doi: 10.1007/s10877-020-00537-4.

11. Černý V, Chrobok V, Klučka J, Křikava I, Michálek P, Otáhal M, Škola J, Štourač P, Vymazal T. Zajištění obtížných dýchacích cest u dospělých a dětí – doporučený postup. Anest intenzív Med 2019;30:173-186.

12. Terblanche NC, Middleton C, Choi‑‑Lundberg DL, Skinner M. Efficacy of a new dual channel laryngeal mask airway, the LMA Gastro airway, for upper gastrointestinal endoscopy: a prospective observational study. Br J Anaesth 2018;120:353-360.

13. McAleavey F, Michalek P. Aura‑i laryngeal mask as a conduit for elective fibreoptic intubation. Anaesthesia 2010;65:1151.

14. Jagannathan N, Hajduk J, Sohn L, Huang A, Sawardekar A, Gebhardt ER, Johnson K, De Oliveira GS. A randomised comparison of the Ambu AuraGain and the LMA Supreme in infants and children. Anaesthesia 2016;71:205-212.

15. Shariffuddin II, Teoh W, Tang E, Hashim N, Loh PS. Ambu AuraGain versus LMA Supreme Second Seal: a randomised controlled trial comparing oropharyngeal leak pressures and gastric drain functionality in spontaneously breathing patients. Anaesth Intensive Care 2017;45:244-250.

16. Mihara T, Nakayama R, Ka K, Goto T. Comparison of the clinical performance of i‑gel and Ambu AuraGain in children: a randomised noninferiority clinical trial. Eur J Anaesthesiol 2019;36:411-417.

17. Moser B, Audigé L, Keller C, Brimacombe J, Gasteiger L, Bruppacher HR. A prospective, randomized trial of the Ambu AuraGain laryngeal mask versus the LMA Protector airway in paralyzed, anesthetized adult men. Minerva Anestesiol 2018;84:684-692.

18. Moser B, Keller C, Audigé L, Dave MH, Bruppacher HR. Fiberoptic intubation of severely obese patients through supraglottic airway: a prospective, randomised trial of Ambu AuraGain laryngeal mask vs the i‑gel airway. Acta Anaesthesiol Scand 2019;63:187-194.

19. Bruceta MA, Dalal PG, McAllister P, Prozesky J, Vaida SJ, O’Budde A. Ambu AuraGain versus intubating laryngeal tube suction as a conduit for endotracheal intubation. J Anaesthesiol Clin Pharmacol 2019;35:348-352.

20. Alexiev V, Salim A, Kevin LG, Laffey JG. An observational study of the Baska mask: a novel supraglottic airway. Anaesthesia 2012;67:640-645.

21. Alexiev V, Ochana A, Abdelrahman D, Coyne J, McDonnell JG, O’Toole DP, Neligan P, Laffey JG. Comparison of the Baska mask with the single‑use laryngeal mask airway in low‑risk female patients undergoing ambulatory surgery. Anaesthesia 2013;68:1026-1032.

22. Lopez AM, Munoz‑‑Rojas G, Fontanals M, de San Jose I, Hermoso A, Valero R. Clinical evaluation of the Baska mask laryngeal mask in adult patients in ambulatory surgery. Rev Esp Anestesiol Reanim 2015;62:551-556.

23. Ng CC, Sybil Shah MHB, Chaw SH, Mansor MB, Tan WK, Koong JK, Wang CY. Baska mask versus endotracheal tube in laparoscopic cholecystectomy surgery: a prospective randomized trial. Expert Rev Med Devices 2021;18:203-210.

24. Li MH, Tang HH, Bouniu CJ, Chan JK. A cross‑‑sectional study evaluating the GuardianCPV supraglottic airway in a clinical setting. Anesth Clin Res 2017;8:2.

25. Tiefenthaler W, Eschertzhuber S, Brimacombe J, Fricke E, Keller C, Kaufman, M.A. randomised, non‑crossover study of the GuardianCPV laryngeal mask versus the LMA Supreme in paralysed, anaesthetised female patients. Anaesthesia 2013;68:600-604.

26. Pajiyar AK, Wen Z, Wang H, Ma L, Miao L, Wang G. Comparisons of clinical performance of guardian laryngeal mask with laryngeal mask airway ProSeal. BMC Anesthesiol 2015;15:69.

27. Sng BL, Ithnin FB, Mathur D, Lew E, Han NR, Sia AT. A preliminary assessment of the LMA protector in non‑paralysed patients. BMC Anestesiol 2017;17:26.

28. Chang JE, Kim H, Lee JM, Min SW, Won D, Jun K, Hwang JY. A prospective, randomised comparison of the LMA‑protector and i‑gel in paralyzed, anesthetized patients. BMC Anestesiol 2019;19:118.

29. van Zundert AAJ, Wyssusek KH, Pelecanos A, Roets M, Kumar CM. A prospective randomized comparison of airway seal using the novel vision‑guided insertion of LMA‑Supreme and LMA‑Protector. J Clin Monit Comput 2020;34:285-294.

30. Kotsovolis G, Pliakos I, Panidis S, Gkinas D, Papavramidis T. Comparison between the Protector laryngeal mask airway and the endotracheal tube for minimally invasive thyroid and parathyroid surgery. World J Surg 2019;43:2822-2828.

31. Shariffuddin II, Chaw SH, Ng LW, Lim CH, Zainal Abidin MF, Wan Zakaria WA, Teoh WH. Clinical performance of the LMA Protector airway in moderately obese patients. BMC Anestesiol 2020;20:184.

32. Mendonca C, Tourville CC, Jefferson H, Nowicka A, Patteril M, Athanassoglou V. Fibreoptic‑ guided tracheal intubation through i‑gel and LMA Protector supraglottic airway devices – a randomised comparison. Anaesthesia 2019;74:203-210.

33. Matek J, Kolek F, Klementova O, Michalek P, Vymazal T. Optical devices in tracheal intubation – state of the art in 2020. Diagnostics (Basel) 2021;11:575.

34. Gómez‑Ríos M.Á., Freire‑Vila E., Vízcaíno‑Martínez L., Estévez‑González E. The Totaltrack: An initial evaluation. Br. J. Anaesth. 2015;115:799-800.

35. Gómez‑Río, M.A., Freire‑Vila E., Casans‑Francés R., Pita‑Fernández S. The Totaltrack video laryngeal mask: An evaluation in 300 patients. Anaesthesia. 2019;74:751-757.

36. Gaszynski T. TotalTrack video intubating laryngeal mask in super‑obese patients—Series of cases. Ther. Clin. Risk Manag. 2016;12:335-338.

37. Gómez‑Ríos M.Á., Freire‑Vila E., Calvo‑Vecino J.M. Use of the Totaltrack VLM as a rescue device following failed tracheal intubation. Eur. J. Anaesthesiol. 2019;36:237-239.

38. Torino A, Di Martino D, Fusco P, Collina U, Marullo L, Ferraro F. Hot topics in airway management during gastrointestinal endoskopy. J Gastrointest Dig Syst 2016;6:1.

39. Tran A, Thiruvenkatarajan V, Wahba M, Currie J, Rajbhoj A, van Wijk R, Teo E, Lorenzetti M, Ludbrook G. LMA Gastro Airway for endoscopic retrograde cholangiopancreatography: a retrospective observational analysis. BMC Anestesiol 2020;20:113.

40. Hakim M, Bryant J, Miketic R, Williams K, Erdman SH, Shafy SZ, Kim SS, Tobias JD. Clinical outcomes of a modified laryngeal mask airway (LMA Gastro Airway) during esophagogastroduodenoscopy in children and adolescents: a randomized study. Med Devices (Auckland) 2020;13:277-282.

41. Bergold MN, Kahle S, Schultzik T, Bücheler T, Byhahn C. Intubating laryngeal tube suction disposable: Initial clinical experiences with a novel device for endotracheal intubation. Anaesthetist. 2016;65:30-35.

42. Donaldson W, Abraham A, Deighan M, Michalek P. i‑gel vs AuraOnce laryngeal mask for general anaesthesia with controlled ventilation in paralyzed patients. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2011;155:155-163.

43. Klementova O, Bhoday TK, Werner J, et al. Evaluation of the insertion parameters and complications of the i‑gel Plus airway device for maintaining patent airway during planned procedures under general anaesthesia: a protocol for a prospective multicentre cohort study. BMJ Open 2021;0:e053215.

44. Michalek P, Donaldson W, Vobrubova E, Hakl M. Complications associated with the use of supraglottic airway devices in perioperative medicine. Biomed Res Int 2015;2015:746560.

45. Michalek P, Donaldson WJ, Hinds JD. Tongue trauma associated with the i‑gel supraglottic airway. Anaesthesia 2009;64:692-693.

Labels
Anaesthesiology, Resuscitation and Inten Intensive Care Medicine

Article was published in

Anaesthesiology and Intensive Care Medicine

Issue 1

2022 Issue 1

Most read in this issue
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#