Bobrow B J, Ewy G A. Curr Opin Crit Care 2009; 15(3): 228-33
A discussion on recent findings surrounding the role of ventilation during CPR during OHCA, focusing on whether passive oxygen insufflation is an optimal form of ventilation when compared to intubation and active assisted ventilation. The authors summarise and suggest that training prehospital medical providers to use passive insufflation may increase critical organ perfusion and therefore survival after OHCA.
Janakiraman C, Chethan DB, Wilkes AR, Stacey MR, Goodwin, N. Anaesthesia 2009; 64(6): 674-678
This study compared the performance of i-gel® and cLMA airways in 50 healthy adult patients. The success rate on the first insertion attempt was significantly lower in the i-gel® group. Overall success after two attempts did not show a significant difference, although a change of device size was allowed. Leak pressures and fibreoptic view of the vocal cords were significantly better with the i-gel®, with the two devices producing leak pressures of 20 (i-gel®) and 17cm H2O (cLMA). 14 patients needed a change in i-gel® size.
Link to abstract.
Garza AG, Gratton MC, Salomone JA, Lindholm D, McElroy J, Archer R. Circulation 2009; 119(19): 2597-605
A retrospective observational cohort study reviewing all adult primary ventricular fibrillation and pulseless ventricular tachycardia cardiac arrests before and after protocol changes in the Emergency Medical System in Kansas City in the USA. Survival from out-of-hospital cardiac arrest of presumed cardiac origin improved from 7.5% to 13.9%, and survival to hospital discharge increased from an unadjusted rate of 22.4% to 43.9%. Authors confirm that the protocol changes optimising chest compressions with reduced disruptions improved return of spontaneous circulation and survival to discharge in their patients.
Beylacq L, Bordes M, Semjen F, Cros AM. Acta Anaesthesiol Scand 2009; 53(3): 376-379
This study evaluated the i-gel® in 50 children above 30kg undergoing short-duration surgery. The parameters measured included: ease of insertion, seal pressure, ease of inserting a gastric tube and post operative complications. The first time insertion success rate was 100%. No laryngeal leak occurred. The mean seal pressure was 24.9cm H20. The authors concluded that i-gel® was very easy to insert and that ‘no learning curve is needed before a high success insertion rate is obtained. The i-gel® appears to be safe for paediatric management’.
Link to abstract.
Park SK, Choi GJ, Choi YS, Ahn EJ, Kang H
During the meta-analysis, 12 studies were evaluated to find no significant differences in first attempt success rate, leak pressure and quality of fibreoptic view between the devices. i-gel had a shorter insertion time and lower blood staining incidence, sore throat reports and dysphagia.
Link to abstract