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

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.

Laryngeal mask airway: Is the management of neonates requiring positive pressure ventilation at birth changing?

2006 ◽  
Vol 12 (5) ◽  
pp. 185-192
Author(s):  
Daniele Trevisanuto ◽  
Massimo Micaglio ◽  
Mariangela Pitton ◽  
Mariella Magarotto ◽  
Daniele Piva ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Positive Pressure Ventilation ◽  
Laryngeal Mask ◽  
Positive Pressure

scholarly journals Reflux during positive pressure ventilation via the laryngeal mask airway?

1995 ◽  
Vol 74 (4) ◽  
pp. 490
Author(s):  
J.M.J. VALENTINE ◽  
A.F. STAKES ◽  
M.C. BELLAMY
Keyword(s):  
Laryngeal Mask Airway ◽  
Positive Pressure Ventilation ◽  
Laryngeal Mask ◽  
Positive Pressure

scholarly journals The ProSeal Laryngeal Mask in Myasthenia Gravis

2002 ◽  
Vol 30 (5) ◽  
pp. 671-674 ◽  
Author(s):  
S. V. Gardner ◽  
N. R. Evans
Keyword(s):  
Nitrous Oxide ◽  
Laryngeal Mask Airway ◽  
Myasthenia Gravis ◽  
Positive Pressure Ventilation ◽  
Muscle Relaxants ◽  
Laryngeal Mask ◽  
Positive Pressure ◽  
Axillary Lymph ◽  
Remifentanil Infusion ◽  
Axillary Lymph Node Clearance

This case describes the anaesthesia management of a patient with myasthenia gravis who required mastectomy with axillary lymph node clearance. After withholding medical therapy for the myasthenia preoperatively on the day of surgery, anaesthesia was maintained with halothane, nitrous oxide and a remifentanil infusion. Muscle relaxants were avoided, facilitated by the use of a ProSeal (Intravent, Orthofix, Maidenhead, United Kingdom) laryngeal mask airway for positive pressure ventilation. The ProSeal laryngeal mask airway is a new laryngeal mask device with a modified cuff and a drainage tube which has been shown to have advantages over older designs for use during positive pressure ventilation. The rationale for the management of this patient with myasthenia is discussed.

Sign in / Sign up

Export Citation Format

Share Document