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Minerva Anestesiologica 2020 Aug 04

DOI: 10.23736/S0375-9393.20.14422-5


lingua: Inglese

A randomised trial comparing the Ambu® Aura-i TM and the Ambu® Aura Gain TM laryngeal mask as conduit for tracheal intubation in children

Lukas GASTEIGER 1 , Elgar OSWALD 1, Maya KEPLINGER 1, Gabriel PUTZER 1, Markus LUGER 1, Sabrina NEURURER 2, Christian KELLER 3, Berthold MOSER 4

1 Department of Anaesthesiology and Intensive Care Medicine, Medical University of Innsbruck, Innsbruck, Austria; 2 Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Innsbruck, Austria; 3 Department of Anaesthesiology, Schulthess Klinik, Zürich, Switzerland; 4 Department of Anesthesiology and Intensive Care Medicine, Spital Limmattal, Schlieren, Switzerland


BACKGROUND: The Ambu Aura Gain is a newer second-generation supraglottic airway device designed for fibreoptic bronchoscopy (FOB)-guided tracheal intubation.
METHODS: 57 patients between 18 months and 6 years of age were randomized to receive either the Ambu Aura-I (n:29) or the Ambu Aura Gain (n:28). Primary endpoint was the time for intubation. Secondary endpoints were the time and number of attempts for device insertion, the feasibility of FOB-guided intubation, the oropharyngeal leak pressure (OLP) the fibreoptic grade of laryngeal view and possible complications.
RESULTS: No difference was found in the time for intubation, the time for device insertion or the fibreoptic grade of laryngeal view. First-attempt device insertion was successful in all (n= 28) patients with Aura Gain (100%) and in 27 (97%) with Aura-i. In the Aura-i group one insertion failed. A significant difference in successful intubation was seen between the Aura-i and the Aura Gain (79% vs 100%, respectively, p=0,0011). Also found was a significant difference in the mean OLP (SD) between the Ambu Aura-i and the Ambu Aura Gain (18 (3) vs 20 (3) cm H2O, respectively; mean difference [MD] - 2 cmH2 O; P = 0.005).
CONCLUSIONS: The Ambu Aura Gain served as a reliable device for FOB-guided tracheal intubation. Even if the time for intubation, when intubation was possible did not differ, the Aura-i showed only 79% intubation success, making it a doubtful device for FOB-guided tracheal intubation in cases of emergency and severe hypoxemia in small children.

KEY WORDS: Paediatric airway management; Laryngeal mask; Difficult airway; Fiberoptic guided intubation; Supraglottic airways

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