i-gel® from Intersurgical: clinical evidence listing

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

What’s new in supraglottic airways? Three decades of evolution to tract separation

Viernes DC, Joffe AM, Goldman AJ. Anaesthesiology News Guide to Airway Management 2010; 9-14

This paper describes the history of the gastric channel in supraglottic airways, providing case reports and performance comparisons between devices. The section on the i-gel® states that the device has inferior seal pressure compared to the LMA Proseal®, but that drainage through the gastric channel was comparable. The i-gel® is quicker and easier to place than standard LMAs. A case report is included which describes the successful use of a size five i-gel® in a 63-year-old man with a difficult airway.

Abstract text

 

Airway management for out-of-hospital cardiac arrest - more data required

Nolan JP, Lockey D. Resuscitation 2009; 80(12): 1333-1334

This editorial discusses the options that are available for airway management when cardiac arrest occurs outside a hospital environment. It is stated that supraglottic airways are easier to insert than endotracheal tubes and have the added benefit of allowing chest compressions to continue while they are inserted. The article references i-gel® studies with both positive and negative outcomes. Overall, insertion time was quicker but ventilation was sometimes found to be inadequate. One study showed that the i-gel® had a higher leak pressure than the cLMA, however a German study found that the i-gel® produced a tight seal at 20cm H2O in only around half of the patients involved. Most of the available i-gel® data comes from small studies. Randomised controlled trials are needed to confirm the performance of the i-gel® and other supraglottic airways during CPR.

Link to abstract.

 

Randomised crossover comparison between the i-gel® and the LMA Unique® in anaesthetised, paralysed adults

Uppal V, Gangaiah S, Fletcher G, Kinsella J. Br J Anaesth 2009; 103(6): 882-885

In this study, the i-gel® and LMA Unique® were both used in 39 patients. Leak pressure, insertion attempts, number of airway manipulations and leak volumes were similar for both devices. Insertion time was significantly less for the i-gel® at 12.2s compared to 15.2s for the LMA Unique®. It can be concluded that the i-gel® is a reasonable alternative to the LMA Unique® during controlled ventilation.

Link to abstract.

 

 

Supreme! Or is it?

Kushakovsky V, Ahmad I. Anaesthesia 2009; 64(11): 1262

This letter is a response to a small LMA Supreme® study. The authors say that they have been using the device in patients having nasopharyngeal surgery as it protects the airway from any bleeding and has a gastric channel to remove any blood in the stomach. However, they have reviewed recent research and believe that their current practice may change. In previous studies, the i-gel® has performed as well as the LMA Supreme® even when all i-gel® patients have been given a size 4 device and the LMA Supreme® has been sized correctly. Gastric tube placement in the two devices and the LMA Proseal® is also comparable. The authors are considering the use of the i-gel® or ProSealTM instead of the SupremeTM.

Link to abstract.

Passive oxygen insufflation is superior to bag-valve-mask ventilation for witnessed ventricular fibrillation out-of hospital cardiac arrest

Bobrow B J, Ewy G A, Clark L, Chikani V, Berg R A, Sanders A B, Vadeboncoeur T F, Hilwig R W, Kern K B. Ann Emerg Med 2009; 54(5): 656-62

Retrospective analysis of statewide out-of-hospital cardiac arrests on over 1000 patients receiving either passive ventilation or bag-valve-mask ventilation treatment by paramedics. Adjusted neurologically intact survival between ventilation techniques was the main results category compared. Passive ventilation proved more successful under the terms used.

Abstract text