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Alex Loeckinger - One of the best experts on this subject based on the ideXlab platform.
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large cuff volumes impede posterior pharyngeal mucosal perfusion with the laryngeal tube Airway
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2002Co-Authors: Joseph Brimacombe, Winfried Roth, Christian Keller, Alex LoeckingerAbstract:Purpose The laryngeal tube Airway (LTA) is a new extraglottic Airway Device with a large proximal cuff that inflates in the laryngopharynx and a distal conical cuff that inflates in the hypopharynx. We determine the influence of the cuff volume and anatomic location on pharyngeal mucosal pressures for the LTA.
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does the proseal laryngeal mask Airway prevent aspiration of regurgitated fluid
Anesthesia & Analgesia, 2000Co-Authors: Christian Keller, Joseph Brimacombe, Axel Kleinsasser, Alex LoeckingerAbstract:In this randomized, cross-over cadaver study, we determined whether a new Airway Device, the ProSeal laryngeal mask Airway (PLMA; Laryngeal Mask Company, Henley-on-Thames, UK), prevents aspiration of regurgitated fluid. We studied five male and five female cadavers (6 ‐24 h postmortem). The infusion set of a pressurecontrolled, continuous flow pump was inserted into the upper esophagus and ligated into place. Esophageal pressure (EP) was increased in 2-cm H2O increments. This was performed without an Airway Device (control) and over a range of cuff volumes (0 ‐ 40 mL) for the classic laryngeal mask Airway (LMA), the PLMA with the drainage tube clamped (PLMA clamped) and unclamped (PLMA unclamped). The EP at which fluid was first seen with a fiberoptic scope in the hypopharynx (control), above or below the cuff, or in the drainage tube, was noted. Mean EP at which fluid was seen without any Airway Device was 9 (range 8 ‐10) cm H2O. EP at which fluid was seen was always higher for the PLMA clamped and LMA compared with the control (all, P , 0.0001). The mean EP at which fluid was seen for the PLMA unclamped was similar to the control at 10 (range 8 ‐13) cm H2O. For the PLMA unclamped, fluid appeared from the drainage tube in all cadavers at 10 ‐ 40 mL cuff volume and in 8 of 10 cadavers at zero cuff volume. Mean EP at which fluid was seen above the cuff was similar for the PLMA clamped and LMA at 0 ‐30 mL cuff volume, but was higher for PLMA clamped at 40-mL cuff volume (81 vs 48 cm H2O, P 5 0.006). Mean EP at which fluid was seen below the cuff was similar at 0 ‐10 mL cuff volume, but was higher for the PLMA clamped at 20, 30, and 40 mL cuff volume (62, 68, 73 vs 46, 46, 46 cm H2O, respectively, P , 0.04). For the PLMA clamped and the LMA, fluid appeared simultaneously above and below the cuff at all cuff volumes. We concluded that in the cadaver model, the correctly placed PLMA allows fluid in the esophagus to bypass the pharynx and mouth when the drainage tube is open. Both the LMA, and PLMA with a closed drainage tube, attenuate liquid flow between the esophagus and pharynx. This may have implications for Airway protection in unconscious patients. (Anesth Analg 2000;91:1017‐20)
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does the proseal laryngeal mask Airway prevent aspiration of regurgitated fluid
Anesthesia & Analgesia, 2000Co-Authors: C Keller, Joseph Brimacombe, Axel Kleinsasser, Alex LoeckingerAbstract:In this randomized, cross-over cadaver study, we determined whether a new Airway Device, the ProSeal laryngeal mask Airway (PLMA; Laryngeal Mask Company, Henley-on-Thames, UK), prevents aspiration of regurgitated fluid. We studied five male and five female cadavers (6-24 h postmortem). The infusion set of a pressure-controlled, continuous flow pump was inserted into the upper esophagus and ligated into place. Esophageal pressure (EP) was increased in 2-cm H(2)O increments. This was performed without an Airway Device (control) and over a range of cuff volumes (0-40 mL) for the classic laryngeal mask Airway (LMA), the PLMA with the drainage tube clamped (PLMA clamped) and unclamped (PLMA unclamped). The EP at which fluid was first seen with a fiberoptic scope in the hypopharynx (control), above or below the cuff, or in the drainage tube, was noted. Mean EP at which fluid was seen without any Airway Device was 9 (range 8-10) cm H(2)O. EP at which fluid was seen was always higher for the PLMA clamped and LMA compared with the control (all, P<0.0001). The mean EP at which fluid was seen for the PLMA unclamped was similar to the control at 10 (range 8-13) cm H(2)O. For the PLMA unclamped, fluid appeared from the drainage tube in all cadavers at 10-40 mL cuff volume and in 8 of 10 cadavers at zero cuff volume. Mean EP at which fluid was seen above the cuff was similar for the PLMA clamped and LMA at 0-30 mL cuff volume, but was higher for PLMA clamped at 40-mL cuff volume (81 vs 48 cm H(2)O, P = 0.006). Mean EP at which fluid was seen below the cuff was similar at 0-10 mL cuff volume, but was higher for the PLMA clamped at 20, 30, and 40 mL cuff volume (62, 68, 73 vs. 46, 46, 46 cm H(2)O, respectively, P<0.04). For the PLMA clamped and the LMA, fluid appeared simultaneously above and below the cuff at all cuff volumes. We concluded that in the cadaver model, the correctly placed PLMA allows fluid in the esophagus to bypass the pharynx and mouth when the drainage tube is open. Both the LMA, and PLMA with a closed drainage tube, attenuate liquid flow between the esophagus and pharynx. This may have implications for Airway protection in unconscious patients.
Joseph Brimacombe - One of the best experts on this subject based on the ideXlab platform.
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large cuff volumes impede posterior pharyngeal mucosal perfusion with the laryngeal tube Airway
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2002Co-Authors: Joseph Brimacombe, Winfried Roth, Christian Keller, Alex LoeckingerAbstract:Purpose The laryngeal tube Airway (LTA) is a new extraglottic Airway Device with a large proximal cuff that inflates in the laryngopharynx and a distal conical cuff that inflates in the hypopharynx. We determine the influence of the cuff volume and anatomic location on pharyngeal mucosal pressures for the LTA.
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does the proseal laryngeal mask Airway prevent aspiration of regurgitated fluid
Anesthesia & Analgesia, 2000Co-Authors: Christian Keller, Joseph Brimacombe, Axel Kleinsasser, Alex LoeckingerAbstract:In this randomized, cross-over cadaver study, we determined whether a new Airway Device, the ProSeal laryngeal mask Airway (PLMA; Laryngeal Mask Company, Henley-on-Thames, UK), prevents aspiration of regurgitated fluid. We studied five male and five female cadavers (6 ‐24 h postmortem). The infusion set of a pressurecontrolled, continuous flow pump was inserted into the upper esophagus and ligated into place. Esophageal pressure (EP) was increased in 2-cm H2O increments. This was performed without an Airway Device (control) and over a range of cuff volumes (0 ‐ 40 mL) for the classic laryngeal mask Airway (LMA), the PLMA with the drainage tube clamped (PLMA clamped) and unclamped (PLMA unclamped). The EP at which fluid was first seen with a fiberoptic scope in the hypopharynx (control), above or below the cuff, or in the drainage tube, was noted. Mean EP at which fluid was seen without any Airway Device was 9 (range 8 ‐10) cm H2O. EP at which fluid was seen was always higher for the PLMA clamped and LMA compared with the control (all, P , 0.0001). The mean EP at which fluid was seen for the PLMA unclamped was similar to the control at 10 (range 8 ‐13) cm H2O. For the PLMA unclamped, fluid appeared from the drainage tube in all cadavers at 10 ‐ 40 mL cuff volume and in 8 of 10 cadavers at zero cuff volume. Mean EP at which fluid was seen above the cuff was similar for the PLMA clamped and LMA at 0 ‐30 mL cuff volume, but was higher for PLMA clamped at 40-mL cuff volume (81 vs 48 cm H2O, P 5 0.006). Mean EP at which fluid was seen below the cuff was similar at 0 ‐10 mL cuff volume, but was higher for the PLMA clamped at 20, 30, and 40 mL cuff volume (62, 68, 73 vs 46, 46, 46 cm H2O, respectively, P , 0.04). For the PLMA clamped and the LMA, fluid appeared simultaneously above and below the cuff at all cuff volumes. We concluded that in the cadaver model, the correctly placed PLMA allows fluid in the esophagus to bypass the pharynx and mouth when the drainage tube is open. Both the LMA, and PLMA with a closed drainage tube, attenuate liquid flow between the esophagus and pharynx. This may have implications for Airway protection in unconscious patients. (Anesth Analg 2000;91:1017‐20)
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does the proseal laryngeal mask Airway prevent aspiration of regurgitated fluid
Anesthesia & Analgesia, 2000Co-Authors: C Keller, Joseph Brimacombe, Axel Kleinsasser, Alex LoeckingerAbstract:In this randomized, cross-over cadaver study, we determined whether a new Airway Device, the ProSeal laryngeal mask Airway (PLMA; Laryngeal Mask Company, Henley-on-Thames, UK), prevents aspiration of regurgitated fluid. We studied five male and five female cadavers (6-24 h postmortem). The infusion set of a pressure-controlled, continuous flow pump was inserted into the upper esophagus and ligated into place. Esophageal pressure (EP) was increased in 2-cm H(2)O increments. This was performed without an Airway Device (control) and over a range of cuff volumes (0-40 mL) for the classic laryngeal mask Airway (LMA), the PLMA with the drainage tube clamped (PLMA clamped) and unclamped (PLMA unclamped). The EP at which fluid was first seen with a fiberoptic scope in the hypopharynx (control), above or below the cuff, or in the drainage tube, was noted. Mean EP at which fluid was seen without any Airway Device was 9 (range 8-10) cm H(2)O. EP at which fluid was seen was always higher for the PLMA clamped and LMA compared with the control (all, P<0.0001). The mean EP at which fluid was seen for the PLMA unclamped was similar to the control at 10 (range 8-13) cm H(2)O. For the PLMA unclamped, fluid appeared from the drainage tube in all cadavers at 10-40 mL cuff volume and in 8 of 10 cadavers at zero cuff volume. Mean EP at which fluid was seen above the cuff was similar for the PLMA clamped and LMA at 0-30 mL cuff volume, but was higher for PLMA clamped at 40-mL cuff volume (81 vs 48 cm H(2)O, P = 0.006). Mean EP at which fluid was seen below the cuff was similar at 0-10 mL cuff volume, but was higher for the PLMA clamped at 20, 30, and 40 mL cuff volume (62, 68, 73 vs. 46, 46, 46 cm H(2)O, respectively, P<0.04). For the PLMA clamped and the LMA, fluid appeared simultaneously above and below the cuff at all cuff volumes. We concluded that in the cadaver model, the correctly placed PLMA allows fluid in the esophagus to bypass the pharynx and mouth when the drainage tube is open. Both the LMA, and PLMA with a closed drainage tube, attenuate liquid flow between the esophagus and pharynx. This may have implications for Airway protection in unconscious patients.
Tomoki Nishiyama - One of the best experts on this subject based on the ideXlab platform.
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the supraglottic Airway i gel in comparison with proseal laryngeal mask Airway and classic laryngeal mask Airway in anaesthetized patients
European Journal of Anaesthesiology, 2010Co-Authors: Wonjung Shin, Hong Seuk Yang, Yuseon Cheong, Tomoki NishiyamaAbstract:Background and objectiveThe I-gel is a new single-use supraglottic Airway Device without an inflatable cuff. This study was designed to investigate the usefulness of the I-gel compared with the classic laryngeal mask Airway (cLMA) and ProSeal laryngeal mask Airway (pLMA) in anaesthetized, paralysed
Christian Keller - One of the best experts on this subject based on the ideXlab platform.
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middle ear pressure changes during anesthesia with or without nitrous oxide are similar among Airway Devices
Anesthesia & Analgesia, 2006Co-Authors: Mathias Hohlrieder, Christian Keller, J Brimacombe, Stephan Eschertzhuber, Gunter Luckner, Irene Abraham, Achim Von GoedeckeAbstract:We tested the hypothesis that middle ear pressure (MEP) is influenced by the choice of Airway Device during anesthesia with or without nitrous oxide (N2O) in the gas mixture. Eighty consecutive anesthetized, paralyzed ventilated patients (ASA physical status I–II, 18–65 yr) were randomly allocated for Airway management with the orally inserted tracheal tube, classic laryngeal mask Airway, ProSeal laryngeal mask Airway, or laryngeal tube suction with or without N2O 66% in the gas mixture. MEP was measured from both ears in random order by a blinded observer before induction of anesthesia and every 10 min for 70 min. In the N2O groups, N2O was changed to air after 40 min. There were no differences in MEP among the Airway Devices in the N2O or air groups. MEP was unchanged in the air groups but increased in the N2O groups with N2O (P < 0.0001) and decreased with air (P < 0.02). Baseline values for MEP were similar, but MEP was always higher for the N2O groups (P < 0.001). We conclude that the choice of Airway Device does not influence MEP among orally inserted tracheal tube, classic laryngeal mask Airway, ProSeal laryngeal mask Airway, and laryngeal tube suction during anesthesia with or without N2O in the gas mixture.
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large cuff volumes impede posterior pharyngeal mucosal perfusion with the laryngeal tube Airway
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2002Co-Authors: Joseph Brimacombe, Winfried Roth, Christian Keller, Alex LoeckingerAbstract:Purpose The laryngeal tube Airway (LTA) is a new extraglottic Airway Device with a large proximal cuff that inflates in the laryngopharynx and a distal conical cuff that inflates in the hypopharynx. We determine the influence of the cuff volume and anatomic location on pharyngeal mucosal pressures for the LTA.
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does the proseal laryngeal mask Airway prevent aspiration of regurgitated fluid
Anesthesia & Analgesia, 2000Co-Authors: Christian Keller, Joseph Brimacombe, Axel Kleinsasser, Alex LoeckingerAbstract:In this randomized, cross-over cadaver study, we determined whether a new Airway Device, the ProSeal laryngeal mask Airway (PLMA; Laryngeal Mask Company, Henley-on-Thames, UK), prevents aspiration of regurgitated fluid. We studied five male and five female cadavers (6 ‐24 h postmortem). The infusion set of a pressurecontrolled, continuous flow pump was inserted into the upper esophagus and ligated into place. Esophageal pressure (EP) was increased in 2-cm H2O increments. This was performed without an Airway Device (control) and over a range of cuff volumes (0 ‐ 40 mL) for the classic laryngeal mask Airway (LMA), the PLMA with the drainage tube clamped (PLMA clamped) and unclamped (PLMA unclamped). The EP at which fluid was first seen with a fiberoptic scope in the hypopharynx (control), above or below the cuff, or in the drainage tube, was noted. Mean EP at which fluid was seen without any Airway Device was 9 (range 8 ‐10) cm H2O. EP at which fluid was seen was always higher for the PLMA clamped and LMA compared with the control (all, P , 0.0001). The mean EP at which fluid was seen for the PLMA unclamped was similar to the control at 10 (range 8 ‐13) cm H2O. For the PLMA unclamped, fluid appeared from the drainage tube in all cadavers at 10 ‐ 40 mL cuff volume and in 8 of 10 cadavers at zero cuff volume. Mean EP at which fluid was seen above the cuff was similar for the PLMA clamped and LMA at 0 ‐30 mL cuff volume, but was higher for PLMA clamped at 40-mL cuff volume (81 vs 48 cm H2O, P 5 0.006). Mean EP at which fluid was seen below the cuff was similar at 0 ‐10 mL cuff volume, but was higher for the PLMA clamped at 20, 30, and 40 mL cuff volume (62, 68, 73 vs 46, 46, 46 cm H2O, respectively, P , 0.04). For the PLMA clamped and the LMA, fluid appeared simultaneously above and below the cuff at all cuff volumes. We concluded that in the cadaver model, the correctly placed PLMA allows fluid in the esophagus to bypass the pharynx and mouth when the drainage tube is open. Both the LMA, and PLMA with a closed drainage tube, attenuate liquid flow between the esophagus and pharynx. This may have implications for Airway protection in unconscious patients. (Anesth Analg 2000;91:1017‐20)
Volker Dorges - One of the best experts on this subject based on the ideXlab platform.
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the laryngeal tube s a modified simple Airway Device
Anesthesia & Analgesia, 2003Co-Authors: Volker Dorges, Hartmut Ocker, Markus Steinfath, Volker Wenzel, Klaus GerlachAbstract:The recently introduced single-lumen Laryngeal Tube can be inserted without additional equipment, and was proven in bench models (1,2) and preliminary clinical trials, to effectively ventilate and oxygenate patients with respiratory arrest (3,4) undergoing routine induction of anesthesia. Thus, the
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a comparison of the laryngeal tube with the laryngeal mask Airway during routine surgical procedures
Anesthesia & Analgesia, 2002Co-Authors: Hartmut Ocker, Peter Schmucker, Markus Steinfath, Volker Wenzel, Volker DorgesAbstract:The laryngeal mask Airway (LMA; Laryngeal Mask Company, Henley-on-Thames, UK) is an established Airway Device, whereas the laryngeal tube (LT) is relatively new and therefore not as well investigated. Therefore, the purpose of the present prospective, randomized, controlled trial was to compare the
