Related Experiment Video
Updated: May 5, 2026
Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Elective use of supraglottic airway devices for primary airway management in children with difficult airways
N Jagannathan1, L Sequera-Ramos, L Sohn
1Ann and Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Avenue, Box 19, Chicago, IL, USA.
Insights
Supraglottic airways (SGAs) are effective for managing difficult airways in children, with a 96% success rate in this study. This demonstrates their utility as a primary airway management tool in pediatric anesthesia.
Area of Science:
- Pediatric Anesthesiology
- Airway Management
- Critical Care
Background:
- Supraglottic airways (SGAs) are utilized for difficult airway management in adults and children.
- Limited data exist on SGAs for primary airway management in pediatric patients.
Purpose of the Study:
- To assess the success rates of SGAs for primary airway management in children with difficult airways.
- To evaluate adverse events associated with SGA use in this population.
Main Methods:
- Retrospective analysis of SGA use in a difficult airway population over 4 years.
- Difficult airway defined by history of difficult laryngoscopy or mask ventilation.
- Data collected on patient characteristics, procedure details, SGA type/size, and outcomes.
Main Results:
- 109 pediatric patients with difficult airways received SGAs for primary management.
- Successful SGA placement achieved in 96% of cases.
- Alternative airway required in only 4 patients.
Conclusions:
- Supraglottic airways are effective for primary airway management in children with difficult airways.
- SGAs demonstrate a high success rate and can be safely utilized in this pediatric population.
Background:
Supraglottic airways (SGAs) have an established role in airway management of difficult airways in both adults and children. However, there are limited data regarding the use of SGAs for primary airway management in children. The aim of this study is to assess the success rates and adverse events related to the use of SGAs for primary airway management during anaesthesia in children with difficult airways.
Methods:
A retrospective analysis of SGA use for primary airway management in the difficult airway population in a single centre over a 4-yr period was performed. Difficult airway was defined as either a history of difficult direct laryngoscopy (a documented Cormack and Lehane Grade 3 or greater and the need for an alternate device to direct laryngoscopy for successful tracheal intubation), a history of difficult mask ventilation, or both. The difficult airway condition, patient characteristic data, type and length of procedure, type and size of SGA placed, number of attempts for successful device placement, success/failure associated with the device during anaesthetic maintenance, and complications were recorded.
Results:
A total of 77,272 children received general anaesthesia in a free-standing paediatric institution. Four hundred and fifty-nine patients were reported to have a difficult airway. Of those, 109 received general anaesthesia and an SGA for primary management, meeting the inclusion criteria for this study during a 4-yr period. An SGA was successfully used in 96% of these patients. In four patients, an alternative airway was needed.
Conclusions:
SGAs can be effectively utilized for airway maintenance in the paediatric difficult airway population.
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