title: Evaluation of chest compression effect on airway management with air-Q, aura-i, i-gel, and Fastrack intubating supraglottic devices by novice physicians: a randomized crossover simulation study.
abstract: OBJECTIVE
  In the 2010 American Heart Association guidelines, supraglottic devices (SGDs) such as the laryngeal mask are proposed as alternatives to tracheal intubation for cardiopulmonary resuscitation. Some SGDs can also serve as a means for tracheal intubation after successful ventilation. The purpose of this study was to evaluate the effect of chest compression on airway management with four intubating SGDs, aura-i (aura-i), air-Q (air-Q), i-gel (i-gel), and Fastrack (Fastrack), during cardiopulmonary resuscitation using a manikin.
  
  
  METHODS
  Twenty novice physicians inserted the four intubating SGDs into a manikin with or without chest compression. Insertion time and successful ventilation rate were measured. For cases of successful ventilation, blind tracheal intubation via the intubating SGD was performed with chest compression and success or failure within 30 s was recorded.
  
  
  RESULTS
  Chest compression did not decrease the ventilation success rate of the four intubating SGDs (without chest compression (success/total): air-Q, 19/20; aura-i, 19/20; i-gel, 18/20; Fastrack, 19/20; with chest compression: air-Q, 19/20; aura-i, 19/20; i-gel, 16/20; Fastrack, 18/20). Insertion time was significantly lengthened by chest compression in the i-gel trial (P < 0.05), but not with the other three devices. The blind intubation success rate with chest compression was the highest in the air-Q trial (air-Q, 15/19; aura-i, 14/19; i-gel, 12/16; Fastrack, 10/18).
  
  
  CONCLUSIONS
  This simulation study revealed the utility of intubating SGDs for airway management during chest compression.
authors.affiliation: Department of Anesthesiology, Osaka Medical College, Daigaku-machi 2-7, Takatsuki, Osaka, 569-8686, Japan, koma21century@yahoo.co.jp.
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Komasawa
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Ueki
authors.forename: Yoshiroh
authors.initials: Y
authors.lastname: Kaminoh
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Nishi
mesh_terms: D058109:Airway Management / Q000295:instrumentation / Q000379:methods*; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation / Q000379:methods*; D018592:Cross-Over Studies; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation; D017214:Laryngeal Masks; D008348:Manikins; D010820:Physicians; D014481:United States