Elective use of supraglottic airway devices for primary airway management in children with difficult airways

Narasimhan Jagannathan*, L. Sequera-Ramos, Lisa Sohn, B. Wallis, A. Shertzer, K. Schaldenbrand

*Corresponding author for this work

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)742-748
Number of pages7
JournalBritish Journal of Anaesthesia
Volume112
Issue number4
DOIs
StatePublished - Jan 1 2014

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Airway Management
Equipment and Supplies
Laryngoscopy
General Anesthesia
Maintenance
Pediatrics
Masks
Intubation
Population
Anesthetics
Anesthesia

Keywords

  • difficult airway
  • laryngeal masks paediatric
  • supraglottic airway

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

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abstract = "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.",
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Elective use of supraglottic airway devices for primary airway management in children with difficult airways. / Jagannathan, Narasimhan; Sequera-Ramos, L.; Sohn, Lisa; Wallis, B.; Shertzer, A.; Schaldenbrand, K.

In: British Journal of Anaesthesia, Vol. 112, No. 4, 01.01.2014, p. 742-748.

Research output: Contribution to journalArticle

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T1 - Elective use of supraglottic airway devices for primary airway management in children with difficult airways

AU - Jagannathan, Narasimhan

AU - Sequera-Ramos, L.

AU - Sohn, Lisa

AU - Wallis, B.

AU - Shertzer, A.

AU - Schaldenbrand, K.

PY - 2014/1/1

Y1 - 2014/1/1

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.

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