Teleflex | LMA - Better by Design

Authors

Publication

Resuscitation 2012; 83 (1): 97-100.

Summary

• A study to compare the performance of the LMA Supreme™, LMA Classic™ and LMA ProSeal™ devices when used by inexperienced medical trainees in a neonatal airway management manikin
• The LMA Supreme™ received significantly higher ratings than the LMA Classic™ and the LMA ProSeal™ for perceived ease of insertion and effectiveness of ventilation in a neonatal manikin model
• The use of the LMA Supreme™ by inexperienced medical trainees was effective in rapidly obtaining a patent airway and positive pressure ventilation in a neonatal manikin model

Objectives:

• To compare the performance of the LMA Supreme™, LMA Classic™ and LMA ProSeal™ devices when used by inexperienced medical trainees in a neonatal airway management manikin

Method:

• This was a prospective study that recruited trainee healthcare professionals (paediatric residents, anaesthesia residents, midwifery trainees and nurse trainees) with no experience in the use of LMA devices
• Trainees received a 15-minute standardised training course on the use of the LMA Supreme™, LMA Classic™ and LMA ProSeal™ devices for neonatal resuscitation
• Outcomes of interest were
  • Ease of insertion
  • Time to establish effective ventilation
  • Maximal inflation pressure
• Participants were required to rate the perceived ease of insertion (ranging from 1 [very difficult] to 4 [very easy]) and the perceived effectiveness of ventilation (ranging from 1 [inadequate] to 4 [excellent]) with each device

Results:

• Forty trainee medical personnel were included in the study
• All three devices were successfully inserted within three attempts
  • The rate of success on the first insertion attempt was highest with the LMA Supreme™ (Figure 1)
• The mean time to insertion was lowest with the LMA Supreme™ (Figure 2)

Figure 1. Insertion success rate on the first, second and third attempt with the LMA Supreme™, LMA Classic™ and LMA ProSeal™ by trainee medical personnel (n=40)

• The mean maximal inflation pressure was significantly higher with the LMA Supreme™ than with the LMA Classic™ and the LMA ProSeal™ (36 vs. 28 and 31 cm H₂O; p<0.01)
• The LMA Supreme™ received significantly higher ratings than the LMA Classic™ and the LMA ProSeal™ for perceived ease of insertion (median 4 vs. 3 and 3, respectively; p<0.01) and effectiveness of ventilation (median 4 vs. 3 and 3, respectively; p<0.01)

Figure 2. Insertion time with the LMA Supreme™, LMA Classic™ and LMA ProSeal™ by trainee medical personnel (n=40) (data are shown as mean ± standard deviation)

Conclusions:

• The LMA Supreme™ was effective in rapidly obtaining a patent airway and positive pressure ventilation in a neonatal manikin model when used by inexperienced delivery room trainees
• Insertion time was faster and maximal inflation pressure was higher with the LMA Supreme™ versus the LMA Classic™ and the LMA ProSeal™
• Participants considered the ease of insertion and effectiveness of ventilation with the LMA Supreme™ to be superior to that of the LMA Classic™ and the LMA ProSeal™