The Experts below are selected from a list of 4983 Experts worldwide ranked by ideXlab platform
J Brimacombe - One of the best experts on this subject based on the ideXlab platform.
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flexible bronchoscopic intubation through the auragain Laryngeal Mask versus a slit guedel tube a non inferiority randomized controlled trial
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2017Co-Authors: Berthold Moser, Christian Keller, J Brimacombe, Laurent Audige, Lukas Gasteiger, Heinz R BruppacherAbstract:Purpose AuraGainTM, a novel third-generation Laryngeal Mask, can facilitate insertion of a gastric tube and provide the potential advantage of intubation. Data are lacking on intubation through the AuraGain Laryngeal Mask.
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stability of the lma proseal and standard Laryngeal Mask airway in different head and neck positions a randomized crossover study
European Journal of Anaesthesiology, 2005Co-Authors: J Brimacombe, C KellerAbstract:SummaryBackground and objective:The LMA-ProSeal® Laryngeal Mask airway is a new Laryngeal Mask airway with a modified cuff and drainage tube. We compared oropharyngeal leak pressure, intracuff pressure and anatomical position (assessed fibreoptically) for the Size 5 LMA-ProSeal® Laryngeal Mask airwa
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aspiration of gastric contents during use of a proseal Laryngeal Mask airway secondary to unidentified foldover malposition
Anesthesia & Analgesia, 2003Co-Authors: J Brimacombe, Christian KellerAbstract:The primary function of the drain tube of the ProSealTM Laryngeal Mask airway (PLMA) is to prevent aspiration of regurgitated stomach contents. We report a case of gastric aspiration with the PLMA during a laparoscopic cholecystectomy in a 64-yr-old healthy man secondary to an unidentified foldover malposition. It is imperative that the position and patency of the drain tube be verified in all patients with the PLMA. IMPLICATIONS: We report a case of gastric aspiration with the ProSealTM Laryngeal Mask during a laparoscopic cholecystectomy secondary to an unidentified foldover malposition. It is imperative that the position and patency of the drain tube be verified in all patients with the ProSealTM Laryngeal Mask.
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positive pressure ventilation with the proseal versus classic Laryngeal Mask airway a randomized crossover study of healthy female patients
Anesthesia & Analgesia, 2001Co-Authors: J Brimacombe, Christian Keller, Michael Boehler, F PuhringerAbstract:IMPLICATIONS: The ProSeal and classic Laryngeal Mask airways are equally effective ventilatory devices in healthy female patients at tidal volumes of 8 and 12 mL/kg with the cuff semi- or fully inflated, but leakage of small volumes of air from the mouth occurs more frequently with the Laryngeal Mask airway.
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gastric insufflation with the proseal Laryngeal Mask
Anesthesia & Analgesia, 2001Co-Authors: J Brimacombe, Christian Keller, Alison BerryAbstract:T he ProSeal Laryngeal Mask airway (PLMA) (Laryngeal Mask Company, Henley-on-Thames, UK) is a new airway device with a large double cuff that forms a better seal than the standard Laryngeal Mask airway; it also has a drainage tube designed to protect against regurgitation, facilitate passage of a gastric tube, reduce the risk of gastric insufflation, and facilitate the detection of malposition (1). The test for malposition involves placing a small volume of a water-based lubricating jelly in the proximal end of the drainage tube, applying positive pressure to the airway tube, and observing the meniscus of the jelly to determine whether there is an air leak up the drainage tube. The presence of an air leak suggests that the distal end of the drainage tube and the airway tube are not isolated and that the PLMA is malpositioned. We describe a patient undergoing laparoscopic cholecystectomy who developed gastric insufflation despite a negative malposition test and make recommendations for improving the reliability of the test for malposition.
Christian Keller - One of the best experts on this subject based on the ideXlab platform.
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flexible bronchoscopic intubation through the auragain Laryngeal Mask versus a slit guedel tube a non inferiority randomized controlled trial
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2017Co-Authors: Berthold Moser, Christian Keller, J Brimacombe, Laurent Audige, Lukas Gasteiger, Heinz R BruppacherAbstract:Purpose AuraGainTM, a novel third-generation Laryngeal Mask, can facilitate insertion of a gastric tube and provide the potential advantage of intubation. Data are lacking on intubation through the AuraGain Laryngeal Mask.
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Protein cross-contamination during batch cleaning and autoclaving of the ProSeal Laryngeal Mask airway.
Anaesthesia, 2006Co-Authors: E Richards, Joseph Brimacombe, W. Laupau, Christian KellerAbstract:We tested the hypothesis that protein cross-contamination occurs during batch cleaning and autoclaving of a reusable extraglottic airway device, the ProSeal™ Laryngeal Mask airway. At the end of each day for 10 days, nine Laryngeal Mask airways that had been used for non-intra-oral surgery were cleaned and autoclaved alongside a new unused Laryngeal Mask airway. In addition, a new unused Laryngeal Mask airway underwent the same cleaning and autoclaving procedures in isolation. Protein staining was more frequently detected on the unused Laryngeal Mask airways that were processed by batch rather than in isolation (p < 0.01). Protein staining was detected on all unused Laryngeal Mask airways that were processed by batch, but none on those processed in isolation. Protein staining was more severe with the used compared with the unused Laryngeal Mask airways (p < 0.001). We conclude that protein cross-contamination of the Laryngeal Mask airway occurs during batch cleaning and autoclaving and recommend that reusable airway devices are cleaned in isolation.
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aspiration of gastric contents during use of a proseal Laryngeal Mask airway secondary to unidentified foldover malposition
Anesthesia & Analgesia, 2003Co-Authors: J Brimacombe, Christian KellerAbstract:The primary function of the drain tube of the ProSealTM Laryngeal Mask airway (PLMA) is to prevent aspiration of regurgitated stomach contents. We report a case of gastric aspiration with the PLMA during a laparoscopic cholecystectomy in a 64-yr-old healthy man secondary to an unidentified foldover malposition. It is imperative that the position and patency of the drain tube be verified in all patients with the PLMA. IMPLICATIONS: We report a case of gastric aspiration with the ProSealTM Laryngeal Mask during a laparoscopic cholecystectomy secondary to an unidentified foldover malposition. It is imperative that the position and patency of the drain tube be verified in all patients with the ProSealTM Laryngeal Mask.
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positive pressure ventilation with the proseal versus classic Laryngeal Mask airway a randomized crossover study of healthy female patients
Anesthesia & Analgesia, 2001Co-Authors: J Brimacombe, Christian Keller, Michael Boehler, F PuhringerAbstract:IMPLICATIONS: The ProSeal and classic Laryngeal Mask airways are equally effective ventilatory devices in healthy female patients at tidal volumes of 8 and 12 mL/kg with the cuff semi- or fully inflated, but leakage of small volumes of air from the mouth occurs more frequently with the Laryngeal Mask airway.
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gastric insufflation with the proseal Laryngeal Mask
Anesthesia & Analgesia, 2001Co-Authors: J Brimacombe, Christian Keller, Alison BerryAbstract:T he ProSeal Laryngeal Mask airway (PLMA) (Laryngeal Mask Company, Henley-on-Thames, UK) is a new airway device with a large double cuff that forms a better seal than the standard Laryngeal Mask airway; it also has a drainage tube designed to protect against regurgitation, facilitate passage of a gastric tube, reduce the risk of gastric insufflation, and facilitate the detection of malposition (1). The test for malposition involves placing a small volume of a water-based lubricating jelly in the proximal end of the drainage tube, applying positive pressure to the airway tube, and observing the meniscus of the jelly to determine whether there is an air leak up the drainage tube. The presence of an air leak suggests that the distal end of the drainage tube and the airway tube are not isolated and that the PLMA is malpositioned. We describe a patient undergoing laparoscopic cholecystectomy who developed gastric insufflation despite a negative malposition test and make recommendations for improving the reliability of the test for malposition.
Peter Baskett - One of the best experts on this subject based on the ideXlab platform.
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randomized crossover comparison of the proseal with the classic Laryngeal Mask airway in unparalysed anaesthetized patients
BJA: British Journal of Anaesthesia, 2002Co-Authors: T. M. Cook, Chandy Verghese, P J Strube, J M Millar, M. Lees, Jerry P Nolan, Peter BaskettAbstract:Background. The ProSeal is a wire-reinforced Laryngeal Mask airway with an additional drain tube that leads to the distal tip of the Laryngeal cuff. The design should improve the seal with the larynx. Methods. The ProSeal and classic Laryngeal Mask airways were compared in 180 patients in a randomized crossover study. Patients were anaesthetized without neuromuscular blocking drugs. Results. The ProSeal took more time and more attempts to insert successfully than the classic Laryngeal Mask airway. Insertion was successful on the first attempt in 81% of cases with the ProSeal and 90% with the classic Laryngeal Mask airway. The ProSeal required more air to achieve an intracuff pressure of 60 cm H2O (6 ml more for size 4 and 12 ml more for size 5). Laryngeal seal pressure was better with the ProSeal than the classic Laryngeal Mask airway. Median seal pressure was 29 cm H2O with the ProSeal and 18 cm H2O with the classic Laryngeal Mask airway. Laryngeal seal pressure was greater than 20 cm H2O in 87% of patients with the ProSeal and 41% with the classic Laryngeal Mask airway. Laryngeal seal pressure was greater than 40 cm H2O in 21% of patients with the ProSeal and in none of the patients with the classic Laryngeal Mask. Once placed, the ProSeal remained a stable and effective airway. Gastric tube insertion through the drain tube was attempted in 147 cases and was successful in 135 (92%). Conclusion. The ProSeal is more difficult to insert than the classic Laryngeal Mask airway but allows positive pressure ventilation more reliably than the classic Laryngeal Mask airway. Br J Anaesth 2002; 88: 527‐33
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the intubating Laryngeal Mask results of a multicentre trial with experience of 500 cases
Anaesthesia, 1998Co-Authors: Peter Baskett, Michael Parr, Jerry P NolanAbstract:A multicentre trial of the use of the intubating Laryngeal Mask was carried out at seven centres in the United Kingdom using the same agreed protocol. Lung ventilation followed by blind tracheal intubation through the intubating Laryngeal Mask was attempted on 500 ASA grade 1 and 2 patients. It was possible to insert the intubating Laryngeal Mask in all 500 cases. Ventilation via the intubating Laryngeal Mask was described as satisfactory in 475 (95%) cases, difficult in 20 (4%) cases and unsatisfactory in 5 (1%) cases. Blind tracheal intubation through the intubating Laryngeal Mask was possible in 481 (96.2%) cases within three attempts. Intubation was successful at the first attempt in 399 (79.8%) cases, at the second attempt in 62 (12.4%) cases and at the third attempt in 20 (4%) cases. The tracheas of 19 (3.8%) patients were not successfully intubated within the three attempts. Ventilation via the intubating Laryngeal Mask was described as unsatisfactory during two of these cases but oxygenation remained satisfactory in spite of this. Seventeen of the 19 failures occurred during the individual operator's first 20 attempts. The intubating Laryngeal Mask provides a successful method for blind tracheal intubation in a large proportion of cases and appears to be superior to the standard Laryngeal Mask airway for this purpose. The intubating Laryngeal Mask may be of use when tracheal intubation has failed using conventional methods.
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the intubating Laryngeal Mask use in failed and difficult intubation
Anaesthesia, 1998Co-Authors: Michael Parr, M Gregory, Peter BaskettAbstract:The use of the intubating Laryngeal Mask in three patients is described. In two patients for whom tracheal intubation using traditional techniques had failed, the intubating Laryngeal Mask was used to achieve successful tracheal intubation. The trachea of one of these patients was subsequently re-intubated for a second procedure using the same technique. A third patient with a cervical spine fracture whose trachea was electively intubated using the intubating Laryngeal Mask is also presented.
Frances Chung - One of the best experts on this subject based on the ideXlab platform.
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oropharyngeal leak pressure with the Laryngeal Mask airway supreme at different intracuff pressures a randomized controlled trial
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2011Co-Authors: Lianfeng Zhang, Edwin Seet, David T. Wong, Vanita Mehta, Rajeev Subramanyam, Saravanan Ankichetty, Frances ChungAbstract:Background A higher oropharyngeal leak pressure (OLP) is a marker of efficacy and safety when using Laryngeal Mask airway devices. The new disposable Laryngeal Mask airway (LMA™) Supreme™ has lower OLP compared with the LMA ProSeal™. Increased intracuff pressure of Laryngeal Mask airway devices may improve OLP but may result in more postoperative pharyngoLaryngeal adverse events. This study was designed to compare the OLP of the LMA Supreme at varying intracuff pressures.
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safety and efficacy of Laryngeal Mask airway supreme versus Laryngeal Mask airway proseal a randomized controlled trial
European Journal of Anaesthesiology, 2010Co-Authors: Edwin Seet, Subramanyam Rajeev, Tamal Firoz, Farhanah Yousaf, Jean Wong, David T. Wong, Frances ChungAbstract:Background and objectiveThe Supreme Laryngeal Mask airway (LMA) is a new single-use polyvinyl chloride supraglottic device that combines the functionality of the ProSeal and Fastrach airways. High oropharyngeal leak pressures are important as they indicate airway protection, feasibility of positive
Takashi Asai - One of the best experts on this subject based on the ideXlab platform.
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awake tracheal intubation through the Laryngeal Mask in neonates with upper airway obstruction
Pediatric Anesthesia, 2007Co-Authors: Takashi Asai, Atsushi Nagata, Koh ShinguAbstract:Summary Neonates with Pierre Robin or Treacher-Collins syndrome are at risk of upper airway obstruction and may require surgical fixation of the tongue to the mandible. Such neonates are at high risk of hypoxia during induction of anesthesia and thus awake fiberoptic intubation would be required. We experienced neonates in whom awake fiberoptic intubation could not be carried out, because of severe hypoxia. Awake insertion of the Laryngeal Mask solved this problem. A 1-month-old neonate with Pierre Robin syndrome and another with Treacher-Collins syndrome were scheduled for surgical fixation of the tongue to the mandible, for constant upper airway obstruction. In both patients, awake fiberoptic intubation was attempted but abandoned, because SpO2 rapidly decreased during the attempts. Awake insertion of the Laryngeal Mask relieved upper airway obstruction and facilitated oxygenation. Fiberoptic intubation through the Laryngeal Mask was easily achieved. Anesthesia was then induced. No hypoxia occurred after insertion of the Laryngeal Mask. In a further two neonates with Treacher-Collins syndrome and in one neonate with Pierre Robin syndrome, awake fiberoptic intubation through the Laryngeal Mask was also successful. We believe that in neonates with predicted difficult intubation, who are at risk of upper airway obstruction and awake fiberoptic intubation could aggregate hypoxia, awake insertion of the Laryngeal Mask can be useful in facilitating oxygenation (by relieving upper airway obstruction) and in facilitating fiberoptic intubation.
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the Laryngeal tube compared with the Laryngeal Mask insertion gas leak pressure and gastric insufflation
BJA: British Journal of Anaesthesia, 2002Co-Authors: Takashi Asai, Ikuhiro Hidaka, Akira Kawashima, S. KawachiAbstract:Results. It was possible to ventilate through the Laryngeal tube in 21 patients and through the Laryngeal Mask in 21 patients. The mean leak pressure for the Laryngeal tube (26 (SD 5) cm H2O) was significantly greater than that for the Laryngeal Mask (19 (4) cm H2O) (P<0.01; 95% confidence intervals for mean difference: 5.3‐10.2 cm H2O). Gastric insufflation did not occur when the Laryngeal tube was used and was noted in three patients when the Laryngeal Mask was used. Conclusion. The Laryngeal tube provides a better seal in the oropharynx than the Laryngeal
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cuff volume and size selection with the Laryngeal Mask
Anaesthesia, 2000Co-Authors: Takashi Asai, J BrimacombeAbstract:By the year 2000, the Laryngeal Mask will have been used in approximately 100 million patients worldwide. Currently, at least 30% of anaesthetised patients in the UK [1] and 20% of patients in the USA [2] are managed using the Laryngeal Mask. The popularity of the device stems from its ease of use, its role in the difficult airway and the advantages it offers over the face Mask and tracheal tube [3, 4]. The advent of the Laryngeal Mask has certainly forced anaesthetists to re-consider the practice of routine airway management as a whole. In many circumstances in which intubation and ventilation was once considered mandatory, the Laryngeal Mask has been used safely, and may even offer advantages. For example, the Laryngeal Mask can be used during adenotonsillectomy and is associated with fewer complications, such as aspiration of blood, than tracheal intubation [5]. Although the Laryngeal Mask has a low failure and complication rate, considerable efforts have been made to improve its clinical success and to make its use even safer. One recent advance is in the selection of appropriate size and cuff volume of the Laryngeal Mask. We felt it appropriate to summarise current knowledge of this issue and to make evidencebased recommendations for clinical practice.
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the view of the glottis at laryngoscopy after unexpectedly difficult placement of the Laryngeal Mask
Anaesthesia, 1996Co-Authors: Takashi AsaiAbstract:Summary In 12 patients to whom a non-depolarising neuromuscular relaxant had been given and in whom placement of the Laryngeal Mask had failed unexpectedly, the view of the larynx at laryngoscopy and the ease of tracheal intubation were examined. The glottis was only partially seen at laryngoscopy in three patients and was not seen at all in another three patients. Tracheal intubation was difficult in three of them. It would appear that in some patients both placement of the Laryngeal Mask and tracheal intubation are difficult. It is thus inadvisable to paralyse patients electively and rely on the Laryngeal Mask to secure a clear airway when tracheal intubation is predicted to be difficult.
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the Laryngeal Mask airway its features effects and role
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 1994Co-Authors: Takashi Asai, Stephen MorrisAbstract:The Laryngeal Mask airway was designed as a new concept in airway management and has been gaining a firm position in anaesthetic practice. Numerous articles and letters about the device have been published in the last decade, but few large controlled trials have been performed. Despite widespread use, the definitive role of the Laryngeal Mask has yet to be established. In some situations, such as after failed tracheal intubation or in anaesthesia for patients undergoing laparoscopic or oral surgery, its use is controversial. There are a number of unresolved issues, for example the effect of the Laryngeal Mask on regurgitation and whether or not cricoid pressure prevents placement of the Mask. We review the techniques of insertion, details of misplacement, and complications associated with the use of the Laryngeal Mask. We discuss the features and physiological effects of the device, including the changes in intra-cuff pressure during anaesthesia and effects on blood pressure, heart rate and intra-ocular pressure. We then attempt to clarify the role of the Laryngeal Mask in airway management during anaesthesia, based on the current knowledge, by discussing the advantages and disadvantages as well as the indications and contraindications of its use. Lastly we describe the use of the Laryngeal Mask in circumstances other than airway maintenance during anaesthesia: fibreoptic bronchoscopy, tracheal intubation through the Mask and its use in cardiopulmonary resuscitation.
