A prospective crossover study comparing six current generation supraglottic airway device's ability to seal during CPR in human cadavers.

Abstract

BackgroundSupraglottic Airway (SGA) devices are frequently used during CPR, but little is known about their ability to consistently seal the airway during CPR. Aim of StudyThe objective of this prospective crossover human cadaver study was a comparison of intrathoracic pressures generated during automated CPR (aCPR) with an ITD (Impedance Threshold Device, Zoll™) with six currently available SGAs to a standard endotracheal tube (ETT). The hypothesis was that current SGAs would vary in their ability to develop intrathoracic pressures compared to the ETT. MethodsAirway pressures (AP) and negative intrathoracic pressures (ITP) were measured in six recently deceased human cadavers of varying body habitus. After placement of an ETT and six different SGAs, we assessed airway and intrathoracic pressures during automated CPR and manual positive pressure ventilation using bag valve mask (BVM). The ETT served as the control for airway seal and was placed first followed by each SGA. Primary outcome compared airway and ITP between all groups. ResultsSGAs varied in their ability to create negative airway pressure and negative ITP. ConclusionIn this human cadaver model, the ability to generate negative ITP varied with different SGAs during aCPR with an ITD.