title: Laryngeal tube suction II for difficult airway management in neonates and small infants.
abstract: OBJECTIVE
  Difficult paediatric airways, both expected and unexpected, present major challenges to every anaesthesiologist, paediatrician and emergency physician. However, the integration of supraglottic airway devices, such as the laryngeal mask (LM), into the algorithm of difficult airways has improved the handling of difficult airway situations in patients. A recent device for establishing a supraglottic airway is the laryngeal tube, introduced in 1999. We report on the successful use of the laryngeal tube suction II (LTS II) in securing the airway when endotracheal intubation or alternative mask ventilation has failed.
  
  
  METHODS
  The use of the LTS II in 10 cases of difficult airway management in neonates and infants <6 months was reviewed.
  
  
  RESULTS
  Use of the LTS II was associated with a high level of success (100%), often rescuing the airway when other techniques had failed. All insertions were successful on first attempt using a modified insertion technique. Placement was classified as "easy" by all users.
  
  
  CONCLUSIONS
  The potential advantage of the LTS II is the suction port which allows gastric tube placement and subsequent egression of gastric contents. In emergency situations when direct laryngoscopy fails, or is too time-consuming because of anatomical abnormalities, we recommend the LTS II tube as the first-line device to secure the airway. As with all supraglottic airways, familiarity and clinical experience with the respective device and its insertion technique is essential for safe and successful use, especially in emergencies.
authors.affiliation: Department of Anaesthesiology, Intensive Care Medicine and Pain Management, Goethe-University Medical School, Frankfurt/Main, Germany. scheller@em.uni-frankfurt.de
authors.forename: Bertram
authors.initials: B
authors.lastname: Scheller
authors.forename: Richard
authors.initials: R
authors.lastname: Schalk
authors.forename: Christian
authors.initials: C
authors.lastname: Byhahn
authors.forename: Norman
authors.initials: N
authors.lastname: Peter
authors.forename: Nanette
authors.initials: N
authors.lastname: L'Allemand
authors.forename: Paul
authors.initials: P
authors.lastname: Kessler
authors.forename: Dirk
authors.initials: D
authors.lastname: Meininger
mesh_terms: D000367:Age Factors; D001835:Body Weight; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007440:Intubation / Q000295:instrumentation*; D008297:Male; D012121:Respiration, Artificial; D013396:Suction / Q000295:instrumentation*