i-gel® from Intersurgical: clinical evidence listing

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

Tongue trauma associated with the i-gel® supraglottic airway

Michalek P, Donaldson WJ, Hinds JD. Anaesthesia 2009; 64(6): 692-693

This article includes three cases of patient injury caused by the i-gel®. In the first case, a paramedic had difficulty inserting the device. It was removed immediately and it was found that the patient was bleeding from the frenulum. The second patient’s tongue was caught in the bowl of the i-gel® during insertion. Although the i-gel® was repositioned successfully, there was minor swelling and bleeding upon removal. This patient reported soreness for three days. The final case involved an insertion which appeared successful, however the patient reported a sore tongue and loss of taste lasting three weeks. The authors recommend two alternative insertion techniques to avoid mouth injuries – sliding the i-gel® over the thumb into the mouth or rotating the device so the tongue cannot get caught.

Link to abstract.

Ventilation during resuscitation efforts for out-of-hospital primary cardiac arrest

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.

Abstract text

A randomised crossover trial comparing the i-gel® supraglottic airway and classic laryngeal mask airway

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.

 

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.