i-gel® from Intersurgical: clinical evidence listing

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.

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.

Ahn E, Choi G, Kang H, Baek C, Jung Y, Woo Y, Bang S. PLoS One. 2018 Nov 5;13(11):e0206804

This network meta-analysis (with a mixed-treatment comparison method to combine direct and indirect comparisons) compared the effectiveness of seven different SADs as a strategy for unassisted tracheal intubation. The primary outcome was the overall success rate of intubation by intention to treat (ITT) and the secondary outcomes included the overall tracheal intubation success rate (per protocol - PP) and the success rate of tracheal intubation at first attempt by ITT and PP.

Link to abstract.

Lopez NT, McCoy SK, Carroll C, Jones E, Miller JA. Mil Med. 2018 Jun 19 [Epub ahead of print]

Prospective crossover study on cadavers to measure airway exchange on three pre-placed supraglottic airways: King LT, i-gel and LMA Unique. Participants, recruited from emergency medical personnel in a training lab, rated the difficulty level of placement of each airway device. Successful exchange equalled proper placement of the ETT in the trachea. Authors conclude the i-gel superior for blind airway exchange with an ETT in this set up.

Link to abstract.

Gawlowski P, Smereka J, Madziala M, Szarpak L, Frass M, Robak O. Am J Emerg Med. 2017 Mar; 35(3): 484-487.

Paramedics performed standard intubation and blind intubation in three airway scenarios. Results show that blind intubation with the i-gel was superior to ETI performed by paramedics.

Link to abstract.