Supraglottic Airway Versus Endotracheal Tube During Interventional Pulmonary Procedures

A Retrospective Study

Kyle M. Behrens; Richard E. Galgon


BMC Anesthesiol. 2019;19(196) 

In This Article


During the study period, 2081 encounters meeting the study inclusion criteria were identified. From these, 783 records were analyzed after exclusions (see Figure 1 for study flow diagram). Overall, 39.3, 57.3, and 3.4% of the patients underwent flexible diagnostic bronchoscopy with or without transtracheal fine needle aspiration biopsy, endobronchial ultrasound (EBUS) guided transtracheal fine needle aspiration biopsy, and tracheal and/or bronchial laser debulking and/or placement procedures, respectively. Interventional pulmonologists performed these procedures 72.2% of the time, while a thoracic surgeon performed 27.8% of the procedures. General anesthesia was maintained using inhalational agents in the majority of cases (85.7% versus 14.3% for intravenous agents). Five hundred seventeen patients were managed using an ETT, while 266 patients were managed using an SGA, providing study groups for intergroup comparisons.

Figure 1.

Study Flow Diagram

For the intergroup comparisons, baseline patient demographics and device performance characteristics are shown in Table 1. There were no significant differences noted between the comparison groups amongst the baseline characteristics, including characteristics that might suggest an increase risk for pulmonary aspiration, poor SGA fit, or difficult airway management. Endotracheal tube was preferred for flexible bronchoscopy procedures, while SGA was preferred for endobronchial ultrasound guided diagnostic procedures. Tracheal and/or bronchial laser debulking and/or stent procedures showed no preference between airway device usage. With respect to device performance, SGA conversion rate (to ETT) was 0.4% [95% CI: 0.0, 2.3%]. SGA versus ETT use was also associated with a significant reduction in NMBD administration (9.0% [6.1, 13.1%] versus 78.3% [74.6, 81.7%]).