Supraglottic Airway Versus Endotracheal Tube During Interventional Pulmonary Procedures

A Retrospective Study

Kyle M. Behrens; Richard E. Galgon

Disclosures

BMC Anesthesiol. 2019;19(196) 

In This Article

Methods

For this study, after Institutional Review Board review and exemption from informed consent, we performed a retrospective chart review. Consecutive patients who underwent an IP procedure at our institution and were cared for by an anesthesia provider during the period of April 15, 2008 through April 14, 2013 (5 years) were identified and included using anesthesia departmental billing records. A priori exclusion criteria included patients who underwent airway management by facemask, rigid bronchoscopy, or jet ventilation, those who underwent a concurrent surgical procedure and those already intubated at presentation. The primary analysis was focused on comparing the use of an SGA versus ETT for airway maintenance, and the need to convert use of an SGA to an ETT during the procedure (i.e., SGA failure). SGA failure was defined as a need to place an ETT during the procedure secondary to poor airway seal performance. SGA failure did not include incidence of airway placement failure at the initial start of the procedure. The determination to use an SGA or ETT was made by the attending anesthesiologist at the time of the procedure. Data including (1) patient characteristics (e.g., age, gender, weight, height, co-morbid diseases, such as diabetes mellitus, gastroesophageal reflux disease, hiatal hernia, or a history of neck radiation, known airway management difficulties, and airway exam findings), (2) procedure type (e.g., flexible bronchoscopy, endobronchial ultrasound, endobronchial tumor debulking, super dimensional bronchoscopy, etc.), and (3) anesthetic management characteristics (e.g., intravenous versus inhalational agent use, ventilation mode, and NMBD), were defined a priori and extracted for secondary exploratory analyses. NMBD use was recorded if an intermediate acting NMBD was administered or re-dosed during the procedure. If a short acting NMBD (succinylcholine) was given to facilitate airway management device placement and no other NMBDs were administered, NMBD use was not counted. Descriptive statistics (mean (SD) and percent) were used to characterize group data. Intergroup comparisons (SGA versus ETT) were performed using t-tests for continuous data and chi square or Fisher's exact tests for categorical data, using GraphPad Prism (Version 5.0, GraphPad Software Inc., La Jolla, CA). Statistical significance was considered at a p-level < 0.05.

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