Lower cuff pressures improve the seal of pediatric laryngeal mask airways

Licina, A. and Chambers, N. A. and Hullett, B. and Erb, T. O. and von Ungern Sternberg, B. S.. (2008) Lower cuff pressures improve the seal of pediatric laryngeal mask airways. Pediatric anesthesia, Vol. 18, H. 10. pp. 952-956.

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Official URL: http://edoc.unibas.ch/dok/A6004210

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BACKGROUND: Hyperinflation of laryngeal mask airway (LMA) cuffs may be harmful because of the exertion of high pressures on pharyngeal and laryngeal structures. Although cuff manometers may be used to monitor cuff pressure, their use is not routine in many institutions and clinical endpoints are used instead. Furthermore, it is common clinical practice to add air to the cuff in the presence of an air leak to obtain a better seal. METHODS: In a prospective audit, the authors assessed air leakage around pediatric sized LMAs (n = 200) following inflation guided by common clinical endpoints (slight outward movement of the LMA) and then following adjustment of the cuff pressure to the recommended pressure range (120 cmH(2)O (size 1) and the median leakage around the cuff ranged from 0.66 to 1.07 ml x kg(-1). Following cuff pressure adjustment according to the recommended pressure range (>60 cmH(2)O), the leakage decreased significantly to 0.51-0.79 ml x kg(-1) (P = 0.002 for size 1, P > 0.001 for size 1.5-3). CONCLUSION: The use of clinical endpoints to inflate LMA cuffs is not only associated with significant hyperinflation in the majority of patients but also with an increased leakage around the LMA cuff when compared with adjusted LMA cuff pressures. Therefore, cuff manometers should routinely be used not only to avoid unnecessary hyperinflation but also to improve cuff sealing of LMA in children.
Faculties and Departments:03 Faculty of Medicine > Bereich Querschnittsfächer (Klinik) > Anästhesiologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Querschnittsfächer (Klinik) > Anästhesiologie
UniBasel Contributors:Erb, Thomas O.
Item Type:Article, refereed
Article Subtype:Research Article
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:25 Apr 2014 08:00
Deposited On:25 Apr 2014 08:00

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