title: A randomized crossover comparison between the Laryngeal Mask Airway-Unique™ and the air-Q intubating laryngeal airway in children.
abstract: OBJECTIVE
  The purpose of this randomized crossover study was to evaluate the feasibility of the air-Q intubating laryngeal airway (ILA) in clinical practice when compared with the Laryngeal Mask Airway-Unique(™) (LMA-U), the current standard of care for primary airway maintenance.
  
  
  OBJECTIVE
  We hypothesized that the ILA would have better airway seal pressures and laryngeal alignment than the LMA-U in anesthetized nonparalyzed children.
  
  
  BACKGROUND
  The ILA is a newer supraglottic airway for children with design features that allow it to be used for primary airway maintenance and as a conduit for tracheal intubations.
  
  
  METHODS
  Fifty healthy children, 6-36 months of age, 10-15 kg, who were scheduled for elective surgery in which the use of a size two LMA-U and size 1.5 ILA would be appropriate for airway maintenance, were enrolled into this randomized crossover study. Primary outcome measures were airway leak pressures and fiberoptic grades of view. Secondary outcome measures included ease and time for successful insertion, incidence of gastric insufflation, ventilation parameters, and complications.
  
  
  RESULTS
  There were no statistically significant differences in regard to the ease of device insertion, time to ventilation, gastric insufflation, and ventilation parameters between the ILA and the LMA-U. All devices were successfully placed on the first attempt, and there were no instances of failure. There were statistically significant differences in the airway leak pressure between the ILA (19.0 ± 5.4 cmH(2)O) and the LMA-U (16.1 ± 4.9 cmH(2)O), P = 0.001. There were also statistically significant differences in the fiberoptic grades of view between the ILA and LMA-U, P = 0.004.
  
  
  CONCLUSIONS
  The ILA had higher airway leak pressures and superior fiberoptic grades of view when compared with the LMA-U and can be a suitable alternative to the LMA-U in children weighing 10-15 kg.
authors.affiliation: Children's Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL 60614, USA. simjag2000@yahoo.com
authors.forename: Narasimhan
authors.initials: N
authors.lastname: Jagannathan
authors.forename: Lisa E
authors.initials: LE
authors.lastname: Sohn
authors.forename: Ravinder
authors.initials: R
authors.lastname: Mankoo
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Langen
authors.forename: Tessa
authors.initials: T
authors.lastname: Mandler
mesh_terms: D002675:Child, Preschool; D003371:Cough / Q000209:etiology; D018592:Cross-Over Studies; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007223:Infant; D007327:Insufflation; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods; D017214:Laryngeal Masks / Q000009:adverse effects; D008297:Male; D011175:Positive-Pressure Respiration; D011183:Postoperative Complications / Q000453:epidemiology; D015656:Respiratory Mechanics / Q000502:physiology; D016896:Treatment Outcome