title: Intubating laryngeal mask airway in morbidly obese and lean patients: a comparative study.
abstract: BACKGROUND
  The intubating laryngeal mask airway (ILMA) was designed using the characteristics of healthy-weight subjects but was shown to be an effective airway device in morbidly obese patients. The authors compared airway management quality in morbidly obese and lean patients with use of the ILMA.
  
  
  METHODS
  Fifty morbidly obese and 50 lean patients (mean body mass indexes, 42 and 27 kg/m, respectively) were enrolled in this prospective study. After induction of general anesthesia, characteristics of airway management were judged on safety and efficiency parameters, including success rate at ventilation and intubation and airway management quality criteria, such as the number of patients who required adjustment maneuvers, the number of failed tracheal intubation attempts, the total duration of airway management, and an overall difficulty visual analog scale score.
  
  
  RESULTS
  The ILMA was successfully inserted and adequate ventilation through the ILMA was achieved in all 100 patients. The success rates of tracheal intubation through the ILMA were similar in obese and lean patients (96% and 94%, respectively). The numbers of failed blind tracheal access attempts and patients who required airway-adjustment maneuvers were significantly reduced in obese patients as compared with lean patients. Four obese patients experienced transient episodes of oxygen desaturation (oxygen saturation < 90%) before adequate bag ventilation was established with the ILMA.
  
  
  CONCLUSIONS
  The authors confirmed that the ILMA was an efficient airway device for airway management of both lean and obese patients. In the conditions of this study, the authors observed that airway management with the ILMA was simpler in obese patients as compared with lean patients.
authors.affiliation: Anesthesia Department, Henri Mondor University Hospital of Créteil, Créteil, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Combes
authors.forename: Stéphane
authors.initials: S
authors.lastname: Sauvat
authors.forename: Bertrand
authors.initials: B
authors.lastname: Leroux
authors.forename: Marc
authors.initials: M
authors.lastname: Dumerat
authors.forename: Emanuel
authors.initials: E
authors.lastname: Sherrer
authors.forename: Cyrus
authors.initials: C
authors.lastname: Motamed
authors.forename: Archie
authors.initials: A
authors.lastname: Brain
authors.forename: Gilles
authors.initials: G
authors.lastname: D'Honneur
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D017214:Laryngeal Masks / Q000592:standards* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology*; D011446:Prospective Studies; D013851:Thinness / Q000453:epidemiology*