Abstract
Supraglottic airway devices (SADs) are used to keep the upper airway open to provide unobstructed ventilation. Early (first-generation) SADs rapidly replaced endotracheal intubation and face masks in > 40% of general anesthesia cases due to their versatility and ease of use. Second-generation devices have further improved efficacy and utility by incorporating design changes. Individual second-generation SADs have allowed more dependable positive-pressure ventilation, are made of disposable materials, have integrated bite blocks, are better able to act as conduits for tracheal tube placement, and have reduced risk of pulmonary aspiration of gastric contents. SADs now provide successful rescue ventilation in > 90% of patients in whom mask ventilation or tracheal intubation is found to be impossible. However, some concerns with these devices remain, including failing to adequately ventilate, causing airway damage, and increasing the likelihood of pulmonary aspiration of gastric contents. Careful patient selection and excellent technical skills are necessary for successful use of these devices.
Footnotes
- Correspondence: Satya Krishna Ramachandran MD FRCA, Department of Anesthesiology, University of Michigan Medical School, 1 H427, University Hospital Box 0048, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0048. E-mail: rsatyak{at}med.umich.edu.
Dr Ramachandran presented a version of this paper at the 52nd Respiratory Care Journal Conference, “Adult Artificial Airways and Airway Adjuncts” held June 14 and 15, 2013, in St Petersburg, Florida.
This work was supported by the Department of Anesthesiology, University of Michigan. Dr. Ramachandran is a paid ad hoc consultant to Galleon Pharmaceuticals and Merck. Ms Kumar has disclosed no conflicts of interest.
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