i-gel® from Intersurgical: clinical evidence listing

Nolan J. Resuscitation 2008; 76(1): 1-2

From the abstract: ‘Tracheal intubation has long been regarded as a fundamental and essential component of advanced life support (ALS). It has been assumed that tracheal intubation improves the chances of surviving from cardiac arrest. There are no reliable data to support this belief and there are several reasons why attempted intubation can be harmful, particularly when undertaken by inexperienced individuals.’

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Soar J. Resuscitation 2007; 74(1): 197

This case report detailed use of a size four i-gel® during a cardiac arrest. The i-gel® was inserted in <10 seconds from opening the packet. The author was able to ventilate the patient’s lungs easily using a self-inflating bag-valve device connected to the i-gel®. The patient’s lungs were ventilated asynchronously during chest compressions with no leak. There was no evidence of aspiration. In addition, this case report confirmed the training of five non-anaesthetic trainee doctors to insert the i-gel® and ventilate an anaesthetised patient after minimal instruction. All these trainees rated i-gel® easier to insert than a laryngeal mask airway.

Link to abstract.

Gabbott DA, Beringer R. Resuscitation 2007; 73(1): 161-162

A letter on initial findings following clinical use of i-gel® in 100 patients. In order to evaluate its potential use in a resuscitation setting, the investigators confined their use to a size four device. They used i-gel® on 100 patients undergoing elective surgery under general anaesthesia. The device was used in patients with a weight range of 40-100kg. In 98/100 cases, the i-gel® was adequately positioned on the first or second attempt. The mean and median leak on sustained pressure was 24cmH2O. Airway trauma, demonstrated by visible blood on the device on removal, was only detected on one occasion.There was one case of regurgitation. The gastric fluid was successfully vented through the oesophageal drainage port without any evidence of aspiration.

Link to abstract.

Saissy J-M, Boussignac G, Cheptel E, Rouvin B, Fontaine D, Bargues L, Levecque J-P, Michel A, Brochard L. Anesthesiology 2000; 92(6): 1523-30

Adult patients who had suffered nontraumatic OHCA with asystole were randomised into two groups: an IPPV group tracheally intubated with a standard tube and a continuous insufflation of air or oxygen (CIO) through microcannulas inserted into a modified endotracheal tube at a rate of 15l/min. Both groups underwent active cardiac compression-decompression with a device. Resuscitation continued for a maximum of 30 minutes, with blood gas analysis taken once stable spontaneous cardiac activity restored. Results for both groups were comparable. Arterial blood gas measure taken upon admission to hospital showed that partial pressure of arterial carbon dioxide was significantly lower in the CIO group, but pH was significantly higher. Authors conclude CIO is as effective as IPPV during OHCA.

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