i-gel® from Intersurgical: clinical evidence listing

Featuring all known evidence on the use of i-gel in a resuscitation and pre-hospital setting, the booklet includes even more adult, paediatric and manikin studies, case reports and a section on cardiocerebral resuscitation and passive oxygenation.

During the current COVID-19 pandemic, i-gel remains an important option for managing the airway in the emergency and pre-hospital setting, so the opportunity to review the published evidence for the device at this time is particularly valuable.

You can now download the PDF from the i-gel website and through the Education page.

Clinical evidence on the i-gel is also available to view on our evidence database, which includes all studies mentioned in both this bibliography and the standard version.

We hope you find the bibliography and clinical database useful in reviewing evidence published on the i-gel device.

Pejovic N, Trevisanuto D, Lubulwa C, Myrnerts Höök S, Cavallin F, Byamugisha J,  Nankunda J, Tylleskär T. Arch Dis Child. 2018 Mar;103(3):255-260.

This phase two, single-centre, prospective, open-label RCT was carried out at the Mulago National Referral Hospital (Uganda) to assess and compare the safety and performance of the i-gel vs. the face mask (FM) during neonatal resuscitation. 50 patients were randomly assigned into two groups, the i-gel (n=25) and the FM group (m=25). Results showed that the total ventilation time was shorter in the I-gel group compared to the FM one mean 93 vs. 140s, p=0.02). All interventions were successful in the I-gel group, but 11 patients from the FM group were transferred to the I-gel one after 150s. In addition, the mean time to spontaneous breathing was 153s (SD59) with the I-gel and 216s with the FM (SD92) (p=0.005). The study estimated a 31% (95%CI 11 to 44%) reduction in spontaneous breathing when using i-gel. No adverse events were reported when using i-gel (e.g. laryngospasm, bleeding or vomiting), but two patients suffered hypoxic ischaemic encephalopathy in the FM group, and one died within the first 48 hours of life. Thus, the use of a cuffless LMA device may help in reducing the time of spontaneous breathing in neonatal resuscitation compared to FM devices.

Link to abstract.

Kim JG, Kim W, Kang GH, Jang YS, Choi HY, Kim H, Kim M. Clin Exp Emerg Med. 2018 Mar 30;5(1):29-34. 

This prospective randomised crossover study was carried out to evaluate the performance and efficacy of the i-gel blind intubation (IGI) in airway management for pre-hospital trauma patients. Here, two blind intubation techniques were assessed (by 18 paramedics) using two supraglottic airway devices (IGI and LMA Fastrach) and a Macintosh laryngoscope (MCL).

Link to abstract.

Baratto F, Gabellini G, Paoli A, Boscolo A. Am J Emerg Med. 2017 Jan 26

Report of two cases of attempted suicide by firearm managed with the use of the i-gel O2 Resus Pack. In both patients, laryngoscopy attempts failed before an i-gel was inserted and either fibreoptic-assisted intubation or fibreoptic bronchoscopy were performed. Authors conclude that the i-gel's properties mean the device could easily be used by untrained rescuers and might perform an important role during out-of-hospital emergency.

Link to abstract.

Häske D, Schempf B, Niederberger C, Gaier G. Am J Emerg Med. 2016;34(2):340

Report of two cases where i-gel was successfully used in a prehospital setting on patients with severe head and neck trauma. Authors suggest that, on evidence, i-gel is an 'appropriate primary airway tool'.

Link to abstract