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Clinical performance of the LMA Protector (TM) airway in moderately obese patients

Background: The 4th National Audit Project of The Royal College of Anaesthetists and The Difficult Airway Society (NAP4) reported a higher incidence of supraglottic airway device (SAD) related pulmonary aspiration in obese patients especially with the first-generation SADs. The latest single-use SAD...

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Main Authors: Shariffuddin, Ina Ismiarti, Chaw, Sook Hui, Ng, Ling Wei, Lim, Ching Hooi, Abidin, Mohd Fitry Zainal, Zakaria, Wan A. Wan, Teoh, Wendy H.
Format: Article
Published: BMC 2020
Subjects:
R Medicine
RA Public aspects of medicine
Online Access:http://eprints.um.edu.my/36533/
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spelling my.um.eprints.365332024-11-26T08:33:05Z http://eprints.um.edu.my/36533/ Clinical performance of the LMA Protector (TM) airway in moderately obese patients Shariffuddin, Ina Ismiarti Chaw, Sook Hui Ng, Ling Wei Lim, Ching Hooi Abidin, Mohd Fitry Zainal Zakaria, Wan A. Wan Teoh, Wendy H. R Medicine RA Public aspects of medicine Background: The 4th National Audit Project of The Royal College of Anaesthetists and The Difficult Airway Society (NAP4) reported a higher incidence of supraglottic airway device (SAD) related pulmonary aspiration in obese patients especially with the first-generation SADs. The latest single-use SAD, the Protector (TM) provides a functional separation of the respiratory and digestive tracts and its laryngeal cuff with two ports allowing additional suction in tandem with the insertion of a gastric tube. The laryngeal cuff of LMA Protector (TM) allows a large catchment reservoir in the event of gastric content aspiration. Methods: We evaluated the performance characteristics of the LMA Protector (TM) in 30 unparalysed, moderately obese patients. First attempt insertion rate, time for insertion, oropharyngeal leak pressure (OLP), and incidence of complications were recorded. Results: We found high first and second attempt insertion rates of 28(93%) and 1(33%) respectively, with one failed attempt where no capnography trace could be detected, presumably from a downfolded device tip. The LMA Protector (TM) was inserted rapidly in 21.0(4.0) seconds and demonstrated high OLP of 31.8(5.4) cmH2O. Fibreoptic assessment showed a clear view of vocal cords in 93%. The incidence of blood staining on removal of device was 48%, postoperative sore throat 27%, dysphagia 10% and dysphonia 20% (all self-limiting, resolving a few hours postoperatively). Conclusions: We conclude that the LMA Protector (TM) was associated with easy, expedient first attempt insertion success, demonstrating high oropharyngeal pressures and good anatomical position in the moderately obese population, with relatively low postoperative airway morbidity. BMC 2020-07 Article PeerReviewed Shariffuddin, Ina Ismiarti and Chaw, Sook Hui and Ng, Ling Wei and Lim, Ching Hooi and Abidin, Mohd Fitry Zainal and Zakaria, Wan A. Wan and Teoh, Wendy H. (2020) Clinical performance of the LMA Protector (TM) airway in moderately obese patients. BMC Anesthesiology, 20 (1). ISSN 1471-2253, DOI https://doi.org/10.1186/s12871-020-01100-z <https://doi.org/10.1186/s12871-020-01100-z>. 10.1186/s12871-020-01100-z
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic R Medicine
RA Public aspects of medicine
spellingShingle R Medicine
RA Public aspects of medicine
Shariffuddin, Ina Ismiarti
Chaw, Sook Hui
Ng, Ling Wei
Lim, Ching Hooi
Abidin, Mohd Fitry Zainal
Zakaria, Wan A. Wan
Teoh, Wendy H.
Clinical performance of the LMA Protector (TM) airway in moderately obese patients
description Background: The 4th National Audit Project of The Royal College of Anaesthetists and The Difficult Airway Society (NAP4) reported a higher incidence of supraglottic airway device (SAD) related pulmonary aspiration in obese patients especially with the first-generation SADs. The latest single-use SAD, the Protector (TM) provides a functional separation of the respiratory and digestive tracts and its laryngeal cuff with two ports allowing additional suction in tandem with the insertion of a gastric tube. The laryngeal cuff of LMA Protector (TM) allows a large catchment reservoir in the event of gastric content aspiration. Methods: We evaluated the performance characteristics of the LMA Protector (TM) in 30 unparalysed, moderately obese patients. First attempt insertion rate, time for insertion, oropharyngeal leak pressure (OLP), and incidence of complications were recorded. Results: We found high first and second attempt insertion rates of 28(93%) and 1(33%) respectively, with one failed attempt where no capnography trace could be detected, presumably from a downfolded device tip. The LMA Protector (TM) was inserted rapidly in 21.0(4.0) seconds and demonstrated high OLP of 31.8(5.4) cmH2O. Fibreoptic assessment showed a clear view of vocal cords in 93%. The incidence of blood staining on removal of device was 48%, postoperative sore throat 27%, dysphagia 10% and dysphonia 20% (all self-limiting, resolving a few hours postoperatively). Conclusions: We conclude that the LMA Protector (TM) was associated with easy, expedient first attempt insertion success, demonstrating high oropharyngeal pressures and good anatomical position in the moderately obese population, with relatively low postoperative airway morbidity.
format Article
author Shariffuddin, Ina Ismiarti
Chaw, Sook Hui
Ng, Ling Wei
Lim, Ching Hooi
Abidin, Mohd Fitry Zainal
Zakaria, Wan A. Wan
Teoh, Wendy H.
author_facet Shariffuddin, Ina Ismiarti
Chaw, Sook Hui
Ng, Ling Wei
Lim, Ching Hooi
Abidin, Mohd Fitry Zainal
Zakaria, Wan A. Wan
Teoh, Wendy H.
author_sort Shariffuddin, Ina Ismiarti
title Clinical performance of the LMA Protector (TM) airway in moderately obese patients
title_short Clinical performance of the LMA Protector (TM) airway in moderately obese patients
title_full Clinical performance of the LMA Protector (TM) airway in moderately obese patients
title_fullStr Clinical performance of the LMA Protector (TM) airway in moderately obese patients
title_full_unstemmed Clinical performance of the LMA Protector (TM) airway in moderately obese patients
title_sort clinical performance of the lma protector (tm) airway in moderately obese patients
publisher BMC
publishDate 2020
url http://eprints.um.edu.my/36533/
_version_ 1817841932958695424
score 13.244413

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