Supraglottic airway: Difference between revisions
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*Dysphagia | *Dysphagia | ||
== | ==Special Considerations== | ||
*There are 2 generations of supraglottic airway devices<ref>Timmermann, A. Supraglottic airways in difficult airway management: successes, failures, use and misuse. Anaesthesia, 2011, | |||
66(Suppl. 2), pages 45–56.</ref> | |||
**1st Gen = classic LMA, other standard LMAs | |||
**2nd Gen = iGel, LMA Supreme, Pro-Seal LMA (PLMA) | |||
*Second generation devices achieve improved esophageal and pharyngeal seal (causes ↑ oropharyngeal leak pressure), incorporate a "drain tube" that allows access to the esophagus and stomach, and usually have an incorporated bite block. | |||
*Oropharyngeal leak pressure = the applied pressure at which the seal between the device and the larynx breaks and begins to leak. | |||
**Inspiratory pressure needs to be less than the oropharyngeal leak pressure for effective ventilation and to prevent gastric insufflation.<ref name="LMA">Patel B., Bingham R. Laryngeal mask airway and other supraglottic airway devices in paediatric practice. Contin Educ Anaesth Crit Care Pain (2009) 9 (1): 6-9.</ref> | |||
==See Also== | ==See Also== | ||
Revision as of 09:59, 27 June 2015
Indications
- Need for positive pressure ventilation (PPV)
Contraindications
- No absolute contraindications
Equipment Needed
- Supraglottic Airway (SGA) device (many options exist)
- Appropriate sedation/paralytic agents, if indicated
| Mask Size | Weight (kg) | Age (yr) | LMA Length (cm) | LMA Cuff Vol (mL) | Largest ETT^ (mm) |
| 1 | <5 | <0.5 | 10 | 4 | 3.5 |
| 1.5 | 5-10 | <1 | 10 | 5-7 | 4 |
| 2 | 6.5-20 | 1-5 | 11.5 | 7-10 | 4.5 |
| 2.5 | 20-30 | 5-10 | 12.5 | 14 | 5 |
| 3 | 30-60 | 10-15 | 19 | 15-20 | 6 |
| 4 | 60-80 | >15 | 19 | 25-30 | 6.5 |
| 5 | >80 | >15 | 19 | 30-40 | 7 |
^Largest ETT that can pass thorough "Intubating LMA" (ILMA)
Procedure
Complications[1]
- Bronchospasm
- Hoarseness
- Laryngeal nerve injury
- Hypoglossal nerve injury
- Pharyngeal edema
- Dysphagia
Special Considerations
- There are 2 generations of supraglottic airway devices[3]
- 1st Gen = classic LMA, other standard LMAs
- 2nd Gen = iGel, LMA Supreme, Pro-Seal LMA (PLMA)
- Second generation devices achieve improved esophageal and pharyngeal seal (causes ↑ oropharyngeal leak pressure), incorporate a "drain tube" that allows access to the esophagus and stomach, and usually have an incorporated bite block.
- Oropharyngeal leak pressure = the applied pressure at which the seal between the device and the larynx breaks and begins to leak.
- Inspiratory pressure needs to be less than the oropharyngeal leak pressure for effective ventilation and to prevent gastric insufflation.[4]
See Also
References
- ↑ 1.0 1.1 Apfelbaum JL, et al.; American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology. 2013 Feb;118(2):251-70
- ↑ Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Cook TM, Woodall N, Frerk C; Fourth National Audit Project. Br J Anaesth. 2011 May;106(5)
- ↑ Timmermann, A. Supraglottic airways in difficult airway management: successes, failures, use and misuse. Anaesthesia, 2011, 66(Suppl. 2), pages 45–56.
- ↑ Patel B., Bingham R. Laryngeal mask airway and other supraglottic airway devices in paediatric practice. Contin Educ Anaesth Crit Care Pain (2009) 9 (1): 6-9.