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Airway rescue in acute upper airway obstruction using a ProSeal ™ Laryngeal mask airway and an Aintree Catheter ™ : a review of the ProSeal ™ Laryngeal mask airway in the management of the difficult airway
Author(s) -
Cook T. M.,
Silsby J.,
Simpson T. P.
Publication year - 2005
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/j.1365-2044.2005.04370.x
Subject(s) - medicine , airway , laryngeal mask airway , airway management , anesthesia , airway obstruction , insertion time , cricothyrotomy , tracheal intubation , catheter , intubation , larynx , laryngeal masks , surgery , laryngoscopy , supraglottic airway
Summary We report the successful use of a ProSeal ™ Laryngeal mask airway (PLMA) to rescue the airway when emergency tracheal intubation and ventilation of the lungs were impossible after haemorrhage into the neck following carotid endarterectomy, despite evacuation of the clot. The airway was re‐established after placement of a PLMA. Fibreoptic examination of the airway revealed severe supraglottic swelling compromising airway patency. An Aintree catheter was placed in the trachea under fibreoptic guidance and a tracheal tube railroaded over this. The use of the PLMA in seven cases of difficult airway management and 11 cases of airway rescue is reviewed. Use of the PLMA was associated with high levels of success, often rescuing the airway when other techniques had failed. No complications of use of the PLMA were reported in these cases. The PLMA appears to be a useful device to assist in management of the difficult airway and for airway rescue. Potential advantages over the classic laryngeal mask airway include improved airway seal and reduced risk of aspiration. The gum elastic bougie‐guided insertion technique is recommended when the PLMA is used for airway rescue.