Featuring all known evidence on the use of i-gel in a resuscitation and pre-hospital setting, the booklet includes even more adult, paediatric and manikin studies, case reports and a section on cardiocerebral resuscitation and passive oxygenation.
During the current COVID-19 pandemic, i-gel remains an important option for managing the airway in the emergency and pre-hospital setting, so the opportunity to review the published evidence for the device at this time is particularly valuable.
You can now download the PDF from the i-gel website and through the Education page.
Clinical evidence on the i-gel is also available to view on our evidence database, which includes all studies mentioned in both this bibliography and the standard version.
We hope you find the bibliography and clinical database useful in reviewing evidence published on the i-gel device.
Bielski A, Smereka J, Madziala M, Golik D, Szarpak L. Eur J Pediatr. 2019 Jun;178(6):871-882
This manikin study aimed to compare the performance of several supraglottic airway devices (SADs) in different blind intubation scenarios performed by 116 inexperienced physicians. The devices used included i-gel, Air-Q laryngeal airway and Ambu AuraGain. The three devices were tested on a paediatric manikin in three different scenarios, which included normal airway without chest compressions (A), normal airway with continuous chest compressions plus the CORPLUS CPR system (CCS) (B), and difficult airway with continuous chest compressions plus CCS (C). Parameters assessed in this investigation included first intubation success rate, median time to SAD placement, time to endotracheal intubation, as well as ease of intubation. Results have shown that the i-gel performed better in every scenario and in all parameters tested as compared to the other devices. Therefore, these data demonstrated that the i-gel is the most effective device for emergency blind intubation performed by inexperienced physicians in paediatric patients.
Link to abstract.
Tracy MB, Priyadarshi A, Goel D, Lowe K, Huvanandana J, Hinder M. Arch Dis Child Fetal Neonatal Ed. 2018 May;103(3)
This manikin study assessed and compared the delivered ventilation of seven, size 1 LMA devices with two different face masks using self-inflating bags (SIBs). 40 participants carried out resuscitation on a specialised infant training manikin using the LMAs and the face masks in a random fashion. Findings have shown that the i-gel had the highest peak inspiratory pressure and higher PEEP compared to the other devices. In addition, the i-gel showed no insertion failures and all users described it as easy to use. Thus, these results indicate that the i-gel may become the primary resuscitation device used for newborn resuscitation.
Link to abstract.
Szarpak Ł. Am J Emerg Med. 2017 Mar;35(3):509-510. Epub 2016 Nov 12.
This study set out to determine the efficacy of blind intubation by novice physicians using the i-gel and the Air-Q devices. Prior the study, a training session focused on anatomy, physiology and pathophysiology of the airways, as well as methods for airway control was provided to all participants. The novice physicians were randomly assigned to either the i-gel or the Air-Q. Several parameters were assessed including time to intubation (primary outcome), time to secure the airway, efficacy of blind intubation and difficulty of the procedure (measured in visual-analogue scale or VAS). Results showed that the time for airway management was 6.5 seconds for the i-gel and 11 seconds for the Air-Q. Time to intubation was significantly shorter when using the i-gel as compared to the Air-Q. Moreover, the effectiveness of intubation was 90% for the i-gel and 78% for the Air-Q. i-gel also had a lower VAS score, and the majority of the participants preferred it to the Air-Q. Therefore, these results suggest that the i-gel represents a better choice for blind intubation by novice physicians when performing CPR.
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.