T HE L ARYNGEAL T UBE : A N EW A DJUNCT FOR A IRWAY M ANAGEMENT

Abstract

Introduction. A prototype of the laryngeal tube was tested for simple and reliable use for ventilation in a mannequin. One possible use of this tube will be the management of the difficult airway. In spite of blind insertion, an inadvertent tracheal positioning should not occur due to the form of the tube. A pharyngeal cuff provides a proximal seal of the airway, while an esophageal cuff seals the airway distally and prevents aspiration of gastric contents. A ventral opening between both cuffs is used for ventilation. Objective. To examine the reliability of the laryngeal tube for airway management in a mannequin. Methods. Fifty physicians and nurses were included in this study and inserted the laryngeal tube blindly during ten consecutive attempts in an advanced life support mannequin. All participants used the laryngeal tube for the first time. Results. During 500 insertions of the tube, correct placement and sufficient ventilation were achieved 478 times in the first attempt (95.6%); 18 times (3.6%), inflating the proximal balloon with an additional 50 mL of air led to sufficient ventilation. In four attempts (0.8%), sufficient ventilation was still not possible due to the tube's not being placed deep enough (according to the printed ring marks on the tube). In each case, the tube was placed correctly in the following attempt. Neither a tracheal intubation nor ventilation of the stomach could be observed. The average time for positioning the laryngeal tube was 27.15 seconds for all 500 attempts (average time of the 50 participants for the tenth attempt: 23.85 seconds). Conclusion. The laryngeal tube may be a fast, reliable, and easy device for airway management. Further research is necessary.