The effect of different inflation volumes of laryngeal mask airway on efficacy of closed circuit controlled ventilation in pediatric cancer patients

• Published in: The Chinese-German journal of clinical oncology Vol. 12; no. 12; pp. 596 - 601
• Main Authors: Azer, Magda S., Ghoneim, Ayman A., Ghobrial, Hossam Z.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2013; Anaesthesia&Pain Management Department, National Cancer Institute, Cairo University, Cairo, Egypt
• Subjects: Cancer Research; Medicine; Medicine & Public Health; Oncology; Surgical Oncology; 小体积; 小儿; 正压通气; 气道; 疗效; 癌症患者; 通货膨胀; 闭路控制; laryngeal mask airway (LMA); leak pressure; closed circuit; intracuff volume; controlled ventilation; pediatric; intracuf volume; control ed ventilation
• ISSN: 1610-1979; 1613-9089
• DOI: 10.1007/s10330-013-1253-4

Objective： The laryngeal mask airway （LMA） is an established way for airway control during spontaneous ventila- tion. Its ability to deliver positive pressure ventilation without leakage especially in low flow states is still controversy. The aim of this study is to test the possibility of using LMA in pediatric closed circuit controlled ventilation, and to find out the optimum cuff volume to perform closed system ventilation. Methods： Twenty children scheduled for elective surgeries were enrolled in a crossover study. Laryngeal mask airway was used. In stage I, the cuff was inflated with the maximum volume of air as rec- ommended by the manufacturers. Adjustment of volume of air inflated into the LMA cuff to the minimum volume to obtain the effective seal was done at stage II. The leak pressure, intracuff pressure and the leak volume were measured in both stages. Results： The cuff filling volume was significantly lower compared to the maximum cuff inflation volume in stage I. Leakage values showed significantly less values in stage II of the study with smaller cuff inflation volumes. The airway leakage pressure was significantly lower in stage fl in comparison to stage I. Cuff inflation pressure in stage I showed marked elevation which dropped significantly after adjustment of cuff volume in stage I1. Conclusion： Laryngeal mask airway is an effective tool to provide closed circuit controlled ventilation in pediatrics. Inflation of the cuff by the minimum volume of air needed to reach the just sealing pressure is suggested to minimize the leakage volume.