title: Insertion Success of the Laryngeal Tube in Emergency Airway Management.
abstract: Background. Emergency airway management (AM) is a priority when resuscitating critically ill or severely injured patients. The goal of this study was to determine the success rates of LT insertion during AM. Methods. Studies that included LT first-pass insertion (FPI) and overall-pass insertion (OPI) success by emergency medical services and in-hospital providers performing AM for emergency situations as well as for scheduled surgery published until July 2014 were searched systematically in Medline. Results. Data of 36 studies (n = 1,897) reported a LT FPI success by physicians of 82.5% with an OPI success of 93.6% (p < 0.001). A cumulative analysis of all 53 studies (n = 3,600) led to FPI and OPI success of 80.1% and 92.6% (p < 0.001), respectively. The results of 26 studies (n = 2,159) comparing the LT with the laryngeal mask airway (LMA) demonstrated a FPI success of 77.0 versus 78.7% (p = 0.36) and an OPI success of 92.2 versus 97.7% (p < 0.001). Conclusion. LT insertion failed in the first attempt in one out of five patients, with an overall failure rate in one out of 14 patients. When compared with the LT, the LMA had a cumulative 5.5% better OPI success rate.
authors.affiliation: Emergency Department, University Hospital of Leipzig, 04103 Leipzig, Germany.
authors.forename: Michael
authors.identifier: 0000-0002-4833-0282
authors.initials: M
authors.lastname: Bernhard
authors.affiliation: Emergency Department, University Hospital of Leipzig, 04103 Leipzig, Germany.
authors.forename: André
authors.initials: A
authors.lastname: Gries
authors.affiliation: Emergency Department, University Hospital of Leipzig, 04103 Leipzig, Germany.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Ramshorn-Zimmer
authors.affiliation: Department of Anaesthesiology and Critical Care Medicine, Innsbruck Medical University, 6020 Innsbruck, Austria.
authors.forename: Volker
authors.initials: V
authors.lastname: Wenzel
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine, Section Emergency Medicine, Federal Armed Forces Hospital, 89081 Ulm, Germany.
authors.forename: Bjoern
authors.identifier: 0000-0002-5048-2533
authors.initials: B
authors.lastname: Hossfeld
mesh_terms: D004632:Emergency Medical Services / Q000379:methods*; D006801:Humans; D007830:Larynx; D012151:Resuscitation / Q000295:instrumentation* / Q000379:methods*