i-gel® from Intersurgical: clinical evidence listing

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

Improved patient survival using a modified resuscitation protocol for out-of-hospital cardiac arrest

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.

Abstract text

The i-gel®, a single-use supraglottic airway device with a non-inflatable cuff and an esophageal vent: An observational study in children

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.

A preliminary study of i-gel®: a new supraglottic airway device

Kannaujia A, Srivastava U, Saraswat N, Mishra A, Kumar A, Saxena S. Indian J Anaesth 2009; 53(1): 52-56

50 patients had the i-gel® inserted for ventilation during surgery. The number of insertion attempts, insertion time, manipulations required for an effective airway and seal pressure were recorded. Gastric tube placement and adverse events were also noted where they occurred. Before removal of the device, stability was tested by measuring the expiratory tidal volume with the patient’s head in standard, rotated, chin lift and no-pillow positions. Success rate was 90% at the first attempt and 100% at the second. Median insertion time was 11 seconds. Insertion depth was increased in four patients and a jaw thrust was required in two more. All gastric tubes were placed successfully. Mild cough or postoperative sore throat was seen in a total of four patients. Seal pressure was approximately 20cm H2O. The i-gel® was also found to be stable during head and neck movement.

Link to abstract.

 

Comparison of the i-gel® with the cuffed tracheal tube during pressure-controlled ventilation

Uppal V, Fletcher G, Kinsella J. Br J Anaesth 2009; 102(2): 264-8

In this study, published in the BJA, twenty-five patients were given a standard anaesthetic, followed by insertion of an i-gel. The lungs were ventilated at three different pressures and the difference between the inspired and expired tidal volumes used to calculate the leak volume and leak fraction. The i-gel was then removed and replaced with a conventional tracheal tube, for which similar readings were taken. The results were then compared. From the data taken, the authors concluded that, ‘compared with a tracheal tube there is no significant difference in the gas leak when using an i-gel during PCV with moderate airway pressures’.

Link to abstract.

 

 

Is i-gel® a new revolution among supraglottic airway devices? - a comparative evaluation

Jindal P, Rizvi A, Sharma JP. Middle East J Anesthesiol. 2009; 20(1): 53-58

This study compared i-gel® to two other supraglottic airways in respect of haemodynamic changes, including heart rate, systolic and diastolic blood pressure, mean arterial pressure and rate pressure product. The authors concluded that ‘i-gel® effectively conforms to the perilaryngeal anatomy despite the lack of an inflatable cuff, it consistently achieves proper positioning for supraglottic ventilation and causes fewer haemodynamic changes as compared to other supraglottic airway devices.’

Link to abstract.