i-gel® from Intersurgical: clinical evidence listing

Jain RA, Parikh DA, Malde AD, Balasubramanium B. Indian J Anaesth. 2018 Apr;62(4):269-279

This survey was sent to over 16,000 members of the Indian Society of Anaesthesiologists and given to delegates at the Asian Society of Paediatric Anaesthesiologists conference 2017. Percentage, mean and standard deviation were calculated. Results showed i-gel was the most commonly used device (60%) and 75% of respondents had access to second-generation supraglottic airways.

Link to abstract.

March JA, Tassey TE, Resurreccion NB, Portela RC, Taylor SE. Prehosp Emerg Care. 2018 May-Jun;22(3):385-389.

The aim of this study was to compare the performance of the I-Gel airway (IGA) to the King LT laryngotracheal airway (KA) in a simulated tactical scenario. The evaluation was carried out by assessing the time to successful tube placement on a manikin. Participants were also videomonitored to assess their height exposure above the protection barrier. Finally, participants were questioned on which device they preferred with results favouring i-gel.

Link to abstract.

Pejovic N, Trevisanuto D, Lubulwa C, Myrnerts Höök S, Cavallin F, Byamugisha J,  Nankunda J, Tylleskär T. Arch Dis Child. 2018 Mar;103(3):255-260.

This phase two, single-centre, prospective, open-label RCT was carried out at the Mulago National Referral Hospital (Uganda) to assess and compare the safety and performance of the i-gel vs. the face mask (FM) during neonatal resuscitation. 50 patients were randomly assigned into two groups, the i-gel (n=25) and the FM group (m=25). Results showed that the total ventilation time was shorter in the I-gel group compared to the FM one mean 93 vs. 140s, p=0.02). All interventions were successful in the I-gel group, but 11 patients from the FM group were transferred to the I-gel one after 150s. In addition, the mean time to spontaneous breathing was 153s (SD59) with the I-gel and 216s with the FM (SD92) (p=0.005). The study estimated a 31% (95%CI 11 to 44%) reduction in spontaneous breathing when using i-gel. No adverse events were reported when using i-gel (e.g. laryngospasm, bleeding or vomiting), but two patients suffered hypoxic ischaemic encephalopathy in the FM group, and one died within the first 48 hours of life. Thus, the use of a cuffless LMA device may help in reducing the time of spontaneous breathing in neonatal resuscitation compared to FM devices.

Link to abstract.

Kang H, Lee Y, Lee S, Song Y, Lim TH, Oh J, Lee J, Shin H. PLoS One. 2018 Apr 19;13(4):e0195745

This study carried out an investigation on the use of two respirators (fold- and cup-type) by physicians (n=26) as protection against infections during intubation procedures with three different devices (DL, GlideScope and i-gel). Results showed a lower protection level when wearing the cup-type respirator during intubation with DL (75%) compared to GlideScope (100%) and i-gel (100%). Therefore, the type of airway device selected for intubation may impact on the level of protection of certain types of respirators. However, due to the limited number of respirators tested and the small sample size, additional larger studies are needed to validate these results.

Link to abstract.

Kim JG, Kim W, Kang GH, Jang YS, Choi HY, Kim H, Kim M. Clin Exp Emerg Med. 2018 Mar 30;5(1):29-34. 

This prospective randomised crossover study was carried out to evaluate the performance and efficacy of the i-gel blind intubation (IGI) in airway management for pre-hospital trauma patients. Here, two blind intubation techniques were assessed (by 18 paramedics) using two supraglottic airway devices (IGI and LMA Fastrach) and a Macintosh laryngoscope (MCL).

Link to abstract.