i-gel® from Intersurgical: clinical evidence listing

A comprehensive list of all known published clinical evidence on the device

Cardiocerebral resuscitation improves neurologically intact survival of patients with out-of-hospital cardiac arrest

Kellum M J, Kennedy K W, Barney R, Keilhauer F A, Bellino M, Zuercher M, Ewy G. Ann Emerg Med 2008; 52(3): 244-52

The objective of this study was to compare a newly implemented protocol using the principles of cardiocerebral resuscitation against 2000 American Heart Association Guidelines for treatment of out-of-hospital cardiac arrest. Data was collected retrospectively from the two study groups, each spanning a three-year period. Cerebral performance category scores were used to define the neurological status of survivors, with ‘1’ considered as ‘intact’ survival. Prior to the protocol change, 18 of 92 (20%) survived and 14 (15%) were intact. After the implementation, 42 of 89 (47%) survived and 35 (39%) were intact. Authors conclude that the implementation was associated with ‘a dramatic improvement in neurologically intact survival.’

Abstract text

Use of the epiglottic airway i-gel® during anaesthetic maintenance: first clinical impressions

Mustafaeva MN, Mizikov VM, Kochneva ZV, Vashchinskaia TV, Sarkisova NG, Rusakov MA, Levitskaia NN. Anesteziol Reanimatol 2008; (5): 55-58

This paper describes the development of supraglottic airways and the i-gel® in particular. A review of the available i-gel® literature showed that there are considerable benefits to using the device during general anaesthesia. The experiences of the authors during the use of i-gel® in 34 patients are also described. The authors believe that the i-gel® is suitable for use during anaesthesia and potentially resuscitation. However, more research should be carried out, especially in terms of comparison with other supraglottic airways.

Link to abstract.

 

Use of an i-gel® for airway rescue

Joshi NA, Baird M, Cook TM. Anaesthesia 2008; 63(9): 1010-1026

A middle-aged female patient was scheduled for an elective operation on her hand. She had undergone several general anaesthetics in the past when a cLMA had been used without documented problems. She had a Mallampati score of three and a thyromental distance of 6cm. Face mask ventilation with an oropharyngeal airway was extremely difficult. A pLMA was inserted, but ventilation was not possible. A size four cLMA was also tried with the same result. A size four i-gel® was then inserted. This immediately provided unobstructed ventilation and stable oxygenation saturation of 98%. The authors commented that ‘the i-gel®’s role in difficult airway management remains to be established, but its ease of insertion, short wide airway tube and good airway leak pressures make it a potentially useful airway device in cases of difficult mask ventilation.’

Link to abstract.

i-gel® insertion by novices in manikins and patients

Wharton NM, Gibbison B, Gabbott DA, Haslam GM, Muchatuta N, Cook TM. Anaesthesia 2008; 63(9): 991-995

This study evaluated the performance of i-gel® in manikins and anaesthetised patients when used by novices. The i-gel® was deployed with minimal evidence of patient trauma and 100% insertion success. In their summary, the authors concluded that, ‘i-gel® is rapidly inserted in both manikins and patients by novice users and compares favourably to other supraglottic airways available. Further work determining safety and efficacy during cardio-pulmonary resuscitation is required.’

Link to abstract.

 

Extraglottic airway devices for use in diving medicine - part 3: the i-gel®

Acott CJ. Diving and Hyperbaric Medicine 2008; 38(3): 124-127

This study looked at the use of i-gel® in airway management of a patient in a diving bell or deck decompression chamber. The study highlighted the potential limitations of some supraglottic airways used in Hyperbaric Medicine, such as possible cuff expansion with a decrease in pressure on decompression and change in cuff volume due to gas diffusion as the gas mixtures change, problems not associated with i-gel®. It showed that, subjectively, there was no change in the consistency of the i-gel® at 203 and 283kPa pressure and that no bubbles were detected following decompression from 203, 283 or 608kPa. The i-gel® was also preferred by the Diver Medical Technicians (DMTs) to the alternative device included in the manikin section of the study because it ‘lacked a cuff and was easier to insert from any position’.

Link to abstract.