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Published on: July 14, 2023
A randomised comparison of the Ambu® AuraGain™ and the LMA® supreme in infants and children
N Jagannathan1, J Hajduk1, L Sohn1
1Department of Anesthesia, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
Insights
The Ambu AuraGain and LMA Supreme show similar clinical performance for pediatric mechanical ventilation. Both devices offer comparable airway leak pressures, insertion success, and complication rates in children.
Area of Science:
- Pediatric Anesthesiology
- Critical Care Medicine
- Medical Device Technology
Background:
- Effective airway management is crucial in pediatric mechanical ventilation.
- Supraglottic airway devices are commonly used for this purpose.
- Comparing the clinical performance of different devices is essential for optimizing patient care.
Purpose of the Study:
- To compare the clinical performance of the Ambu AuraGain and LMA Supreme in children requiring mechanical ventilation.
- To evaluate primary outcomes including initial and 10-minute airway leak pressures.
- To assess secondary outcomes such as ease, time, and success rates of device and gastric tube insertion, fiberoptic view, airway quality, and complications.
Main Methods:
- A randomized trial involving 100 children was conducted.
- The study compared the Ambu AuraGain and LMA Supreme for airway maintenance during mechanical ventilation.
- Key performance indicators including airway leak pressures, insertion parameters, and complication rates were assessed.
Main Results:
- No significant differences were found in initial and 10-minute airway leak pressures between the Ambu AuraGain and LMA Supreme.
- Ease, time, and success rates for device and gastric tube insertion, as well as complication rates, were comparable between the two devices.
- Children receiving the LMA Supreme required more airway maneuvers to maintain a patent airway, though this did not reach statistical significance (p=0.06).
Conclusions:
- The Ambu AuraGain demonstrates comparable clinical performance to the LMA Supreme in pediatric patients.
- The Ambu AuraGain may serve as a viable alternative to the LMA Supreme for airway management in children.
- Further research could explore long-term outcomes and specific patient populations.
Abstract:
We conducted a randomised trial in 100 children in order to compare the clinical performance of the Ambu(®) AuraGain(™) and the LMA(®) Supreme(*) for airway maintenance during mechanical ventilation. The primary outcomes were initial and 10-min airway leak pressures. Ease, time and success rates for device and gastric tube insertion, fibreoptic grades of view, airway quality during anaesthetic maintenance, and complications were also assessed. There were no differences in the initial and ten min airway leak pressures between the Ambu AuraGain and LMA Supreme, median (IQR [range]) initial: 19 (16-22 [10-34]) vs 18 (14-24 [8-40]) cmH2 O, p = 0.4; and ten min: 22 (18-26 [11-40]) vs 20 (16-26 [12-40]) cmH2 O, p = 0.08, respectively. Ease, time and success rates for device placement, gastric tube insertion and complications were also not significantly different. Children receiving the LMA Supreme required more airway manouevers (7 vs 1 patient, p = 0.06) to maintain a patent airway. Our results suggest that the Ambu AuraGain may be a useful alternative to the LMA Supreme, as demonstrated by comparable overall clinical performance in children.
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