i-gel® from Intersurgical: clinical evidence listing

Choi HY, Kim W, Jang YS, Kang GH, Kim JG, Kim H. Emerg Med Int. 2019 Oct 31;2019:8913093

This prospective randomized crossover manikin study investigated the intubation performance of I-gel blind intubation (IGI) in comparison to I-gel bronchoscopic intubation (IBRI) and intubation using Macintosh Laryngoscope (MCL). 23 emergency physicians carried out intubations with two different types of ET tubes while performing chest compressions. Assessed outcomes included intubation time (primary) cumulative success rate for each intubation time was significantly shorter as compared to the IBRI and MCL using both ET tubes. On the other hand, the performance of polyvinyl chloride and wire reinforced silicon tubes were comparable for each intubation technique. Moreover, the IGI approach reached 100% intubation success rate in a significantly shorter amount of time as compared to the other techniques. Therefore, the IGI technique is a safe and effective approach when carrying out intubations in emergency scenarios that can be used by experienced intubators when administering chest compressions.

Link to abstract.

Bielski A, Smereka J, Madziala M, Golik D, Szarpak L. Eur J Pediatr. 2019 Jun;178(6):871-882

This manikin study aimed to compare the performance of several supraglottic airway devices (SADs) in different blind intubation scenarios performed by 116 inexperienced physicians. The devices used included i-gel, Air-Q laryngeal airway and Ambu AuraGain. The three devices were tested on a paediatric manikin in three different scenarios, which included normal airway without chest compressions (A), normal airway with continuous chest compressions plus the CORPLUS CPR system (CCS) (B), and difficult airway with continuous chest compressions plus CCS (C). Parameters assessed in this investigation included first intubation success rate, median time to SAD placement, time to endotracheal intubation, as well as ease of intubation. Results have shown that the i-gel performed better in every scenario and in all parameters tested as compared to the other devices. Therefore, these data demonstrated that the i-gel is the most effective device for emergency blind intubation performed by inexperienced physicians in paediatric patients.

Link to abstract.

Tracy MB, Priyadarshi A, Goel D, Lowe K, Huvanandana J, Hinder M. Arch Dis Child Fetal Neonatal Ed. 2018 May;103(3)

This manikin study assessed and compared the delivered ventilation of seven, size 1 LMA devices with two different face masks using self-inflating bags (SIBs). 40 participants carried out resuscitation on a specialised infant training manikin using the LMAs and the face masks in a random fashion. Findings have shown that the i-gel had the highest peak inspiratory pressure and higher PEEP compared to the other devices. In addition, the i-gel showed no insertion failures and all users described it as easy to use. Thus, these results indicate that the i-gel may become the primary resuscitation device used for newborn resuscitation.

Link to abstract.

Liu ZJ, Yi J, Chen WY, Zhang XH, Huang YG. Medicine (Baltimore). 2017 May;96(19):e6905.

46 doctors with no intubation experience were given 20 minutes of airway training and a short practice session with the i-gel and Aura-I. They were then asked to insert each device into a manikin in random order and to attempt intubation through each airway. Time to ventilation, first-attempt and overall intubation success, incidence of gastric inflation, ease of insertion, view of the vocal cords, and insertion score were all recorded and compared. Participants attempted the same tasks at a 3-month follow-up session. First-attempt and overall success rates for intubation were high and comparable, with only 1 patient failing to intubate via the Aura-I at follow-up. Performance of the devices was generally comparable. Time to intubation was shorter with the i-gel at both time points. Participants also reported that the i-gel was easier to use. These results may be due to the lack of inflatable cuff.

Link to abstract

Ladny JR, Bielski K, Szarpak L, Cieciel M, Konski R, Smereka J. Am J Emerg Med. 2017 May; 35(5): 786-787

Manikin study to assess effectiveness of blind intubation through the i-gel, LMA Classic and a standard cuffed tracheal tube, performed by 34 nurses in CPR conditions across two scenarios (with and without chest compressions). Primary measure was time to intubation. i-gel recorded a lower median time to intubation and higher, statistically significant, successful insertion rates in both scenarios. Performing compressions doesn't significantly affect time to perform blind intubation in this setting, but reduces the effectiveness of first intubation attempt. i-gel was faster in both scenarios.

Link to abstract.