TY - JOUR
T1 - Elective use of supraglottic airway devices for primary airway management in children with difficult airways
AU - Jagannathan, N.
AU - Sequera-Ramos, L.
AU - Sohn, L.
AU - Wallis, B.
AU - Shertzer, A.
AU - Schaldenbrand, K.
PY - 2014/4
Y1 - 2014/4
N2 - Background Supraglottic airways (SGAs) have an established role in airway management of difficult airways in both adults and children. However, there are limited data regarding the use of SGAs for primary airway management in children. The aim of this study is to assess the success rates and adverse events related to the use of SGAs for primary airway management during anaesthesia in children with difficult airways. Methods A retrospective analysis of SGA use for primary airway management in the difficult airway population in a single centre over a 4-yr period was performed. Difficult airway was defined as either a history of difficult direct laryngoscopy (a documented Cormack and Lehane Grade 3 or greater and the need for an alternate device to direct laryngoscopy for successful tracheal intubation), a history of difficult mask ventilation, or both. The difficult airway condition, patient characteristic data, type and length of procedure, type and size of SGA placed, number of attempts for successful device placement, success/failure associated with the device during anaesthetic maintenance, and complications were recorded. Results A total of 77 272 children received general anaesthesia in a free-standing paediatric institution. Four hundred and fifty-nine patients were reported to have a difficult airway. Of those, 109 received general anaesthesia and an SGA for primary management, meeting the inclusion criteria for this study during a 4-yr period. An SGA was successfully used in 96% of these patients. In four patients, an alternative airway was needed. Conclusions SGAs can be effectively utilized for airway maintenance in the paediatric difficult airway population.
AB - Background Supraglottic airways (SGAs) have an established role in airway management of difficult airways in both adults and children. However, there are limited data regarding the use of SGAs for primary airway management in children. The aim of this study is to assess the success rates and adverse events related to the use of SGAs for primary airway management during anaesthesia in children with difficult airways. Methods A retrospective analysis of SGA use for primary airway management in the difficult airway population in a single centre over a 4-yr period was performed. Difficult airway was defined as either a history of difficult direct laryngoscopy (a documented Cormack and Lehane Grade 3 or greater and the need for an alternate device to direct laryngoscopy for successful tracheal intubation), a history of difficult mask ventilation, or both. The difficult airway condition, patient characteristic data, type and length of procedure, type and size of SGA placed, number of attempts for successful device placement, success/failure associated with the device during anaesthetic maintenance, and complications were recorded. Results A total of 77 272 children received general anaesthesia in a free-standing paediatric institution. Four hundred and fifty-nine patients were reported to have a difficult airway. Of those, 109 received general anaesthesia and an SGA for primary management, meeting the inclusion criteria for this study during a 4-yr period. An SGA was successfully used in 96% of these patients. In four patients, an alternative airway was needed. Conclusions SGAs can be effectively utilized for airway maintenance in the paediatric difficult airway population.
KW - difficult airway
KW - laryngeal masks paediatric
KW - supraglottic airway
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U2 - 10.1093/bja/aet411
DO - 10.1093/bja/aet411
M3 - Article
C2 - 24322570
AN - SCOPUS:84896970398
SN - 0007-0912
VL - 112
SP - 742
EP - 748
JO - British journal of anaesthesia
JF - British journal of anaesthesia
IS - 4
ER -