title: Insertion characteristics, sealing pressure and fiberoptic positioning of CobraPLA in children.
abstract: BACKGROUND
  The CobraPLA(TM) is a new supraglottic airway device designed for the use in spontaneously breathing and mechanically ventilated patients. In adults it has been found as effective as the LMA, but with better sealing qualities. The aim of the present study was to evaluate fit and sealing characteristics of CobraPLA size 1.5 and 2 in mechanically ventilated children.
  
  
  METHODS
  Forty children, ASA I/II, aged 1-10 years, weighing 10-35 kg were scheduled for minor surgical procedures. The number of attempts for insertion and fiberoptic positioning of the CobraPLA was assessed. After muscle relaxation had been achieved, airway sealing pressure was measured by gradually increasing maximum inspiratory pressure to a maximum of 30 cm H(2)O.
  
  
  RESULTS
  Insertion of CobraPLA was successful at the first attempt in 90% of patients. The vocal cords were visualized in 90% of patients (grade 0: 2.5%, grade 1: 7.5%, grade 2: 30%, grade 3: 15%, grade 4: 45%). Median sealing pressure was 20.0 +/- 6.0 cm H(2)O. In 21% of patients gastric insufflation was observed at a peak inspiratory pressure of 20 cm H(2)O or below.
  
  
  CONCLUSIONS
  The CobraPLA was found to have easy insertion characteristics and good anatomical fitting in children between 10 and 35 kg. If positive pressure ventilation with CobraPLA size 1.5 and 2.0 is required, peak inspiratory pressure should be kept below the leak pressure and the abdomen closely monitored for signs of gastric insufflation.
authors.affiliation: Department of Anaesthesia and Intensive Care, University Hospital, Policlinico Umberto I, Rome, Italy. maurizio.passariello@libero.it
authors.forename: Maurizio
authors.initials: M
authors.lastname: Passariello
authors.forename: Nicole
authors.initials: N
authors.lastname: Almenrader
authors.forename: Bruno
authors.initials: B
authors.lastname: Coccetti
authors.forename: Roberta
authors.initials: R
authors.lastname: Haiberger
authors.forename: Paolo
authors.initials: P
authors.lastname: Pietropaoli
mesh_terms: D000758:Anesthesia / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D008297:Male; D012121:Respiration, Artificial / Q000295:instrumentation