The laryngeal mask airway in infants and children

Chongdoo Park, Jae Hyon Bahk, Won Sik Ahn, Sang Hwan Do, Kook Hyun Lee

Research output: Contribution to journalArticle

125 Citations (Scopus)

Abstract

Purpose: To compare the effectiveness of various laryngeal mask airway (LMA) sizes and their performance during positive pressure ventilation (PPV) in paralyzed pediatric patients. Methods: Pediatric patients (n= 158), < 30 kg, ASA 1 or 2 were studied. After paralysis, an LMA of the recommended size was inserted and connected to a volume ventilator. Fibreoptic bronchoscopy (FOB) was performed and graded: 1, larynx only seen; 2, larynx and epiglottis posterior surface seen; 3, larynx, and epiglottis tip or anterior surface seen-visual obstruction of epiglottis to larynx: < 50%; 4, epiglottis down-folded, and its anterior surface seen-visual obstruction of epiglottis to larynx: > 50%; 5, epiglottis down-folded and larynx not seen directly. Inspiratory and expiratory tidal volumes (VT), and airway pressure were measured by a pneumo-tachometer, and the fraction of leakage (FL) was calculated. In 79 cases, LMA was used for airway maintenance throughout surgery. Results: Successful LMA placement was achieved in 98% of cases: three failures were due to gastric insufflation. For LMA # 1, 1.5, 2, and 2.5, FOB grades [median (range)] were 3(1-5), 3(1-5), 1(1-5) and 1(1-3) respectively. In smaller LMAs, the cuff more frequently enclosed the epiglottis (P < .001). FL of LMA # 1 was higher than those of LMA # 1.5 and LMA # 2.5 (P < .05), and FL of LMA # 2 was higher than that of LMA # 2.5 (P < .05). In the 79 patients, the number of patients experiencing complications decreased as LMA size increased (P < .05). Conclusion: Use of the LMA in smaller children results in more airway obstruction, higher ventilatory pressures, larger inspiratory leak, and more complications than in older children.

Original languageEnglish
Pages (from-to)413-417
Number of pages5
JournalCanadian Journal of Anesthesia
Volume48
Issue number4
DOIs
Publication statusPublished - Jan 1 2001

Fingerprint

Laryngeal Masks
Epiglottis
Pediatrics
Pressure
Insufflation
Positive-Pressure Respiration
Tidal Volume
Airway Obstruction
Larynx
Stomach
Maintenance

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

Park, C., Bahk, J. H., Ahn, W. S., Do, S. H., & Lee, K. H. (2001). The laryngeal mask airway in infants and children. Canadian Journal of Anesthesia, 48(4), 413-417. https://doi.org/10.1007/BF03014975

The laryngeal mask airway in infants and children. / Park, Chongdoo; Bahk, Jae Hyon; Ahn, Won Sik; Do, Sang Hwan; Lee, Kook Hyun.

In: Canadian Journal of Anesthesia, Vol. 48, No. 4, 01.01.2001, p. 413-417.

Research output: Contribution to journalArticle

Park, C, Bahk, JH, Ahn, WS, Do, SH & Lee, KH 2001, 'The laryngeal mask airway in infants and children', Canadian Journal of Anesthesia, vol. 48, no. 4, pp. 413-417. https://doi.org/10.1007/BF03014975
Park, Chongdoo ; Bahk, Jae Hyon ; Ahn, Won Sik ; Do, Sang Hwan ; Lee, Kook Hyun. / The laryngeal mask airway in infants and children. In: Canadian Journal of Anesthesia. 2001 ; Vol. 48, No. 4. pp. 413-417.
@article{205f580b744a4aaf90ec8863734f5e37,
title = "The laryngeal mask airway in infants and children",
abstract = "Purpose: To compare the effectiveness of various laryngeal mask airway (LMA) sizes and their performance during positive pressure ventilation (PPV) in paralyzed pediatric patients. Methods: Pediatric patients (n= 158), < 30 kg, ASA 1 or 2 were studied. After paralysis, an LMA of the recommended size was inserted and connected to a volume ventilator. Fibreoptic bronchoscopy (FOB) was performed and graded: 1, larynx only seen; 2, larynx and epiglottis posterior surface seen; 3, larynx, and epiglottis tip or anterior surface seen-visual obstruction of epiglottis to larynx: < 50{\%}; 4, epiglottis down-folded, and its anterior surface seen-visual obstruction of epiglottis to larynx: > 50{\%}; 5, epiglottis down-folded and larynx not seen directly. Inspiratory and expiratory tidal volumes (VT), and airway pressure were measured by a pneumo-tachometer, and the fraction of leakage (FL) was calculated. In 79 cases, LMA was used for airway maintenance throughout surgery. Results: Successful LMA placement was achieved in 98{\%} of cases: three failures were due to gastric insufflation. For LMA # 1, 1.5, 2, and 2.5, FOB grades [median (range)] were 3(1-5), 3(1-5), 1(1-5) and 1(1-3) respectively. In smaller LMAs, the cuff more frequently enclosed the epiglottis (P < .001). FL of LMA # 1 was higher than those of LMA # 1.5 and LMA # 2.5 (P < .05), and FL of LMA # 2 was higher than that of LMA # 2.5 (P < .05). In the 79 patients, the number of patients experiencing complications decreased as LMA size increased (P < .05). Conclusion: Use of the LMA in smaller children results in more airway obstruction, higher ventilatory pressures, larger inspiratory leak, and more complications than in older children.",
author = "Chongdoo Park and Bahk, {Jae Hyon} and Ahn, {Won Sik} and Do, {Sang Hwan} and Lee, {Kook Hyun}",
year = "2001",
month = "1",
day = "1",
doi = "10.1007/BF03014975",
language = "English",
volume = "48",
pages = "413--417",
journal = "Canadian Journal of Anaesthesia",
issn = "0832-610X",
publisher = "Springer New York",
number = "4",

}

TY - JOUR

T1 - The laryngeal mask airway in infants and children

AU - Park, Chongdoo

AU - Bahk, Jae Hyon

AU - Ahn, Won Sik

AU - Do, Sang Hwan

AU - Lee, Kook Hyun

PY - 2001/1/1

Y1 - 2001/1/1

N2 - Purpose: To compare the effectiveness of various laryngeal mask airway (LMA) sizes and their performance during positive pressure ventilation (PPV) in paralyzed pediatric patients. Methods: Pediatric patients (n= 158), < 30 kg, ASA 1 or 2 were studied. After paralysis, an LMA of the recommended size was inserted and connected to a volume ventilator. Fibreoptic bronchoscopy (FOB) was performed and graded: 1, larynx only seen; 2, larynx and epiglottis posterior surface seen; 3, larynx, and epiglottis tip or anterior surface seen-visual obstruction of epiglottis to larynx: < 50%; 4, epiglottis down-folded, and its anterior surface seen-visual obstruction of epiglottis to larynx: > 50%; 5, epiglottis down-folded and larynx not seen directly. Inspiratory and expiratory tidal volumes (VT), and airway pressure were measured by a pneumo-tachometer, and the fraction of leakage (FL) was calculated. In 79 cases, LMA was used for airway maintenance throughout surgery. Results: Successful LMA placement was achieved in 98% of cases: three failures were due to gastric insufflation. For LMA # 1, 1.5, 2, and 2.5, FOB grades [median (range)] were 3(1-5), 3(1-5), 1(1-5) and 1(1-3) respectively. In smaller LMAs, the cuff more frequently enclosed the epiglottis (P < .001). FL of LMA # 1 was higher than those of LMA # 1.5 and LMA # 2.5 (P < .05), and FL of LMA # 2 was higher than that of LMA # 2.5 (P < .05). In the 79 patients, the number of patients experiencing complications decreased as LMA size increased (P < .05). Conclusion: Use of the LMA in smaller children results in more airway obstruction, higher ventilatory pressures, larger inspiratory leak, and more complications than in older children.

AB - Purpose: To compare the effectiveness of various laryngeal mask airway (LMA) sizes and their performance during positive pressure ventilation (PPV) in paralyzed pediatric patients. Methods: Pediatric patients (n= 158), < 30 kg, ASA 1 or 2 were studied. After paralysis, an LMA of the recommended size was inserted and connected to a volume ventilator. Fibreoptic bronchoscopy (FOB) was performed and graded: 1, larynx only seen; 2, larynx and epiglottis posterior surface seen; 3, larynx, and epiglottis tip or anterior surface seen-visual obstruction of epiglottis to larynx: < 50%; 4, epiglottis down-folded, and its anterior surface seen-visual obstruction of epiglottis to larynx: > 50%; 5, epiglottis down-folded and larynx not seen directly. Inspiratory and expiratory tidal volumes (VT), and airway pressure were measured by a pneumo-tachometer, and the fraction of leakage (FL) was calculated. In 79 cases, LMA was used for airway maintenance throughout surgery. Results: Successful LMA placement was achieved in 98% of cases: three failures were due to gastric insufflation. For LMA # 1, 1.5, 2, and 2.5, FOB grades [median (range)] were 3(1-5), 3(1-5), 1(1-5) and 1(1-3) respectively. In smaller LMAs, the cuff more frequently enclosed the epiglottis (P < .001). FL of LMA # 1 was higher than those of LMA # 1.5 and LMA # 2.5 (P < .05), and FL of LMA # 2 was higher than that of LMA # 2.5 (P < .05). In the 79 patients, the number of patients experiencing complications decreased as LMA size increased (P < .05). Conclusion: Use of the LMA in smaller children results in more airway obstruction, higher ventilatory pressures, larger inspiratory leak, and more complications than in older children.

UR - http://www.scopus.com/inward/record.url?scp=0035000358&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035000358&partnerID=8YFLogxK

U2 - 10.1007/BF03014975

DO - 10.1007/BF03014975

M3 - Article

C2 - 11339788

AN - SCOPUS:0035000358

VL - 48

SP - 413

EP - 417

JO - Canadian Journal of Anaesthesia

JF - Canadian Journal of Anaesthesia

SN - 0832-610X

IS - 4

ER -