Emergency airway management by intensive care unit nurses with the intubating laryngeal mask airway and the laryngeal tube

V Dörges, V Wenzel, E Neubert, P Schmucker, V Dörges, V Wenzel, E Neubert, P Schmucker

Abstract

When using the laryngeal tube and the intubating laryngeal mask airway (ILMA), the medium-size (maximum volume 1100 ml) versus adult (maximum volume 1500 ml) self-inflating bags resulted in significantly lower lung tidal volumes. No gastric inflation occurred when using both devices with either ventilation bag. The newly developed medium-size self-inflating bag may be an option to further reduce the risk of gastric inflation while maintaining sufficient lung ventilation. Both the ILMA and laryngeal tube proved to be valid alternatives for emergency airway management in the experimental model used.

Figures

Figure 1
Figure 1
Intubating laryngeal mask airway.
Figure 2
Figure 2
Laryngeal tube.
Figure 3
Figure 3
Modification of a previously described bench model of positive-pressure ventilation with an unprotected airway [3,33]. The upper airway was provided by a new intubation manikin head. The tracheal outlet of the manikin head was connected to a mechanical test lung (lung compliance 50 ml/cmH2O; airway resistance 16 cmH2O/l per s). The oesophageal outlet of the manikin head was connected to an adjustable PEEP valve, which represented lower oesophageal sphincter pressure. A second outlet from the PEEP valve was connected to a paediatric pneumotachometer in order to record oesophageal peak pressure and gastric inflation. A flow sensor was inserted between the self-inflating bag and the airway device under investigation; another flow sensor was inserted into the simulated trachea. The flow sensors were connected to respiratory monitors in order to measure ventilation variables.

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