Kai Goldmann1, Marc Kalinowski, Stephan Kraft. 1. Department of Anaesthesia and Intensive Care Therapy, Philipps University Marburg, Marburg, Germany. kaigoldmann1@aol.com
Abstract
OBJECTIVE: Evaluation of the LMA-ProSeal for positive pressure ventilation (PPV) in the pig. STUDY DESIGN: Prospective observational study. ANIMALS: Twelve German country pigs, weighing 25-62 kg. METHOD: Lungs of pigs were mechanically ventilated under general anaesthesia using the LMA-ProSeal. The ease of insertion, number of attempts and total time until placement of the LMA-ProSeal and gastric tube were recorded. Bronchoscopy was performed to determine the position of the LMA-ProSeal and to detect signs of aspiration. Ventilation variables and the leak airway pressure (P(leak)) were measured. An arterial blood gas sample was taken to determine the adequacy of ventilation. RESULTS: The airway was secured in all pigs within 39 +/- 19 seconds (27-51). Different sizes of LMA-ProSeal were used; up to 30 kg: size 3, up to 43 kg: size 4; and above 43 kg: size 5. In all but one animal the P-LMA and gastric tube were inserted at the first attempt. In nine animals gastric fluid was drained through the gastric tube. There was no evidence of aspiration in any animal. The mean [+/-SD (95%CI)]P(leak) was 28.8 +/- 7.5 cm H(2)O (24.06-33.60) and normal ventilation was achieved in all animals. CONCLUSIONS: The results of this study indicate that the airway of pigs weighing 25-62 kg can be secured safely and reliably with the sizes 3, 4 and 5 LMA-ProSeal. CLINICAL RELEVANCE: Endotracheal intubation in pigs can be difficult so there is a risk of hypoxemia in the apnoeic animal. With the LMA-ProSeal the airway can be secured rapidly, safely and reliably. Use of the Standard-LMA under PPV can be associated with gas leakage into the stomach and the subsequent risk of gastric distension and regurgitation. Both the ability to drain the stomach and the high P(leak) of the LMA-ProSeal could contribute to improved protection against aspiration under PPV.
OBJECTIVE: Evaluation of the LMA-ProSeal for positive pressure ventilation (PPV) in the pig. STUDY DESIGN: Prospective observational study. ANIMALS: Twelve German country pigs, weighing 25-62 kg. METHOD: Lungs of pigs were mechanically ventilated under general anaesthesia using the LMA-ProSeal. The ease of insertion, number of attempts and total time until placement of the LMA-ProSeal and gastric tube were recorded. Bronchoscopy was performed to determine the position of the LMA-ProSeal and to detect signs of aspiration. Ventilation variables and the leak airway pressure (P(leak)) were measured. An arterial blood gas sample was taken to determine the adequacy of ventilation. RESULTS: The airway was secured in all pigs within 39 +/- 19 seconds (27-51). Different sizes of LMA-ProSeal were used; up to 30 kg: size 3, up to 43 kg: size 4; and above 43 kg: size 5. In all but one animal the P-LMA and gastric tube were inserted at the first attempt. In nine animals gastric fluid was drained through the gastric tube. There was no evidence of aspiration in any animal. The mean [+/-SD (95%CI)]P(leak) was 28.8 +/- 7.5 cm H(2)O (24.06-33.60) and normal ventilation was achieved in all animals. CONCLUSIONS: The results of this study indicate that the airway of pigs weighing 25-62 kg can be secured safely and reliably with the sizes 3, 4 and 5 LMA-ProSeal. CLINICAL RELEVANCE: Endotracheal intubation in pigs can be difficult so there is a risk of hypoxemia in the apnoeic animal. With the LMA-ProSeal the airway can be secured rapidly, safely and reliably. Use of the Standard-LMA under PPV can be associated with gas leakage into the stomach and the subsequent risk of gastric distension and regurgitation. Both the ability to drain the stomach and the high P(leak) of the LMA-ProSeal could contribute to improved protection against aspiration under PPV.
Authors: Robert Ruemmler; Alexander Ziebart; Thomas Ott; Dagmar Dirvonskis; Erik Kristoffer Hartmann Journal: BMC Anesthesiol Date: 2020-08-17 Impact factor: 2.217