Supraglottic Airways: Use in Cardiac Arrest Remains Controversial

We examined whether different SGAs behave the same way when used clinically. Our work builds on prior studies in pigs suggesting that not all SGAs function the same and that some may cause internal strangulation. Our current work also builds on recent studies that were performed using the human cadaver model to study the physiology of CPR. This human cadaver model is particularly useful in that we can measure airway pressures as well as intracranial pressures. The airway and intracranial pressures and changes in those pressures are similar to what we’ve observed in animal models and cardiac arrest in humans. More specifically, we previously reported changes in airway pressures in human cadavers that were identical to what we have observed in humans in cardiac arrest. Because of the importance of the SGA in the bundle of care, as well as the use of the impedance threshold device (ITD), a circulatory adjunct that attaches to the SGA, we assessed in human cadavers the ability of a variety of SGAs to maintain negative intrathoracic pressure during the recoil phase of CPR. Generation of negative intrathoracic pressure with the impedance threshold device is associated with superior outcomes. We studied five different SGAs in seven cadavers, randomizing the order between the five SGAs and an endotracheal (ET) tube. We performed CPR manually, with the LUCAS mechanical chest compression device, and the ACD CPR device called the ResQPUMP, in both the supine position and in the head-u...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Airway & Respiratory Cardiac Resuscitation Exclusive Articles Patient Care Heart of America Top Story Source Type: news