Inconsistent size nomenclature in extraglottic airway devices

Area of Science:

• Anesthesiology
• Emergency Medicine
• Critical Care

Background:

• Extraglottic airway devices (EADs) are common but often have poor seals, leading to leaks.
• Optimal EAD size selection is critical for effective and safe airway management.
• This review examines EAD sizing recommendations to guide optimal device selection.

Purpose of the Study:

• To delineate sizing recommendations for extraglottic airway devices (EADs).
• To identify differences in sizing guidelines to aid optimal device choice.
• To enhance EAD effectiveness and patient safety through proper sizing.

Main Methods:

• Searched manufacturer guidelines for EAD size recommendations.
• Conducted a literature search for alternative EAD size selection suggestions.

Main Results:

• Manufacturers offer a wide range of EAD sizes, often based on weight, but sometimes on age, gender, or height.
• Specialized formulas and methods exist to aid in selecting the optimal EAD size, particularly for pediatric patients.
• Novel 'one-size-fits-all' adult EADs have been introduced.

Conclusions:

• EAD size selection is critical but controversial due to differing recommendations and lack of a universal system.
• Effective EAD use depends on correct sizing, clinical judgment, and patient-specific anatomy/physiology.
• Standardization and consensus on EAD sizing would improve clinical practice and patient safety.