i-gel® from Intersurgical: clinical evidence listing

Adlam M, Purnell D. Resuscitation 2012; 83(5): e129

Twenty-one Foundation Year One Trainees were asked to attempt to ventilate a manikin with either an LMA or i-gel®, of their own choosing. Results showed 71% chose to use an LMA, although on reflection 95% preferred the i-gel®. Speed of insertion was faster with i-gel®. Study supports use of i-gel® on resus trolleys for use by non-airway trained doctors.

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Nolan JP, Ornato JP, Parr MJA, Perkins GD, Soar J. Resuscitation 2012; 83(1): 1-6

The editorial team reports a substantial increase in the number of published studies in Resuscitation during 2010 - here is a summary of the key papers.

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Castle N, Pillay Y, Spencer N. Anaesthesia 2011; 66(11): 983-8

Six different supraglottic airway devices, including i-gel®, were tested by 58 paramedics for speed and ease of insertion in a manikin, whilst wearing either a standard uniform or chemical, biological, radiation, nuclear-person protective equipment (CBRN-PPE). During the latter test, i-gel® was the fastest of the six to insert with a mean insertion time of 19 seconds. Overall, the wearing of CBRN-PPE has a detrimental effect on insertion time of supraglottic airways.

Link to abstract.

Ruetzler K, Gruber C, Nabecker S, Wohlfarth P, Priemayr A, Frass M, Kimberger O, Sessler D, Roessler B. Resuscitation 2011; 82(8): 1060-1063

After an audio-visual lecture and practical demonstration, 40 voluntary emergency medical technicians with limited airway management experience were recruited to perform airway management with six devices, including the i-gel®, during sustained compressions on manikins. Hands-off time was significantly longer when inserting a traditional endotracheal tube, whereas the supraglottic devices were inserted successfully on each occasion.

Link to abstract.

Baker P, Webber J. Anaesth Intensive Care 2011; 39(4): 675-7

Reported failure of an i-gel® and an Ambu® AuraOnceTM to ventilate a drowning victim due to changes in lung physiology following inhalation of water requiring ventilation pressures up to 40cmH20. Authors say that supraglottic airways, thanks to rapid insertion, are recommended for resuscitation as they facilitate the continuation of cardiac compression, however low leak pressures may cause inadequate ventilation and entrainment of air into the stomach of drowning victims.

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