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A prospective randomised controlled trial of the LMA Supreme vs cuffed tracheal tube as the airway device during percutaneous tracheostomy
Author(s) -
Price G. C.,
McLellan S.,
Paterson R. L.,
Hay A.
Publication year - 2014
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.12595
Subject(s) - medicine , airway , anesthesia , tracheal tube , percutaneous , tracheotomy , laryngeal masks , airway management , surgery , laryngeal mask airway
Summary We studied the performance of the LMA Supreme against a cuffed tracheal tube, our standard method of airway control during percutaneous tracheostomy, in 50 consecutive patients from three general critical care units. The primary outcome measure was adequacy of ventilation calculated as the difference in arterial carbon dioxide tension before and after tracheostomy. On an intention‐to‐treat analysis, there was no difference in the increase in arterial carbon dioxide tension between groups, with a median ( IQR [range]) for the LMA Supreme of 0.9 (0.3–1.6 [0–2.8]) kPa, and for the tracheal tube of 0.8 (0.4–1.2 [0–2.5]) kPa, p = 0.82. Eight patients out of 25 (32%) crossed over from the LMA Supreme group to the tracheal tube group before commencement of tracheostomy due to airway or ventilation problems, compared with none out of 25 in the tracheal tube group, p = 0.01, and tracheostomy was postponed in two patients in the LMA Supreme group due to poor oxygenation. There were more clinically important complications in the LMA Supreme group compared with the tracheal tube group.