title: Usability and performance characteristics of the pediatric air-Q® intubating laryngeal airway.
abstract: OBJECTIVE
  The air-Q® intubating laryngeal airway (ILA) is a supraglottic device (SGD) designed specifically to function as both a primary airway and a bridging device and conduit for fibreoptic intubation in difficult airway scenarios. This observational study evaluated the usability and performance characteristics of pediatric air-Q ILA sizes 1.0, 1.5, 2.0, and 2.5 when used as a primary airway.
  
  
  METHODS
  One hundred ten children, American Society of Anesthesiologists physical status I-III and undergoing elective surgery, received a weight-appropriate air-Q ILA following induction of anesthesia. The evaluation criteria included ease of insertion, quality of ventilation, presence of gastric insufflation, oropharyngeal leak pressures (OLPs) and maximum tidal volumes (VT max) in five different head positions, and fibreoptic view of the glottis.
  
  
  RESULTS
  For sizes 1.0, 1.5, 2.0, and 2.5, the median [P25,P75] neutral OLPs (cm H2O) were 23.0 [20.0,30.0], 16.5 [15.0,20.8], 14.0 [10.0,17.8], and 14.0 [11.3,16.8], respectively. The median [P25,P75] neutral VT max values (mL · kg(-1)) were 17.4 [14.3,19.7], 20.3 [16.8,25.5], 17.8 [14.5,22.1], and 14.0 [11.6,16.0], respectively. Median [P25,P75] ease of insertion scores (0-10; 0 = easiest ever, 10 = most difficult ever) were 1 [1,2], 2 [2,3], 2 [1,2.8], and 2 [2,3] respectively. Ventilation was adequate in 108/110 cases, and a fibreoptic view of the vocal cords was obtained in 102/110 cases.
  
  
  CONCLUSIONS
  The air-Q ILA functions acceptably as a primary SGD in infants and children. The OLPs are lower than published values for the ProSeal laryngeal mask airway (LMA ProSeal™), the current pediatric SGD of choice, but adequate tidal volumes are readily achievable. The fibreoptic views of the glottis portend well for fibreoptic intubation through the device. (This trial was registered at clinicaltrials.gov number, NCT00885911).
authors.affiliation: Department of Pediatric Anesthesia, BC Children's Hospital, 1L7-4480 Oak Street, Vancouver, BC V6H 3V4, Canada. swhyte@cw.bc.ca
authors.forename: Simon D
authors.initials: SD
authors.lastname: Whyte
authors.forename: Erin
authors.initials: E
authors.lastname: Cooke
authors.forename: Stephan
authors.initials: S
authors.lastname: Malherbe
mesh_terms: D000293:Adolescent; D000367:Age Factors; D058109:Airway Management / Q000295:instrumentation / Q000379:methods*; D000758:Anesthesia / Q000379:methods; D002648:Child; D002675:Child, Preschool; D017558:Elective Surgical Procedures / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005336:Fiber Optic Technology; D005931:Glottis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017214:Laryngeal Masks; D008297:Male; D056888:Patient Positioning; D013990:Tidal Volume; D014827:Vocal Cords