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Intermittent positive ventilation through a laryngeal mask in children: does it cause gastric dilatation?
Insights
Healthy children over six months can be safely ventilated using a laryngeal mask airway, avoiding gastric distension. This study compared laryngeal mask ventilation to tracheal tube ventilation in pediatric patients.
Area of Science:
- Pediatric Anesthesiology
- Airway Management
Background:
- Gastric distension is a potential complication during positive pressure ventilation in children.
- Laryngeal mask airways (LMAs) are increasingly used in pediatric anesthesia.
Purpose of the Study:
- To compare the incidence of gastric distension in children ventilated with an LMA versus a tracheal tube.
- To evaluate the safety and efficacy of LMA use in pediatric patients.
Main Methods:
- Sixty children (6 months to 10 years, ASA Grade 1 or 2) were randomized to LMA or tracheal tube ventilation.
- Intermittent positive pressure ventilation was used with inflation pressures < 20 cm H2O.
- Gastric gas was aspirated via an orogastric tube for one hour.
Main Results:
- No significant difference in the volume of gastric aspirate was detected between the LMA and tracheal tube groups.
- No large volumes of gas were aspirated from the stomach in either group.
Conclusions:
- Laryngeal mask airways can be safely used for ventilation in healthy children over six months of age.
- LMA ventilation does not lead to significant gastric distension in this pediatric population.
Abstract:
After obtaining Ethics Committee approval and informed consent, sixty children, ASA Grade 1 or 2 and aged six months to ten years, were randomly allocated to receive intermittent positive pressure ventilation through either a laryngeal mask or a tracheal tube. Inflation pressures were maintained below 20 cm H2O, and gas aspirated from the stomach via an orogastric tube over a one h period. No large volumes were aspirated and no differences were detected between the groups. We conclude that healthy children over the age of six months can be safely ventilated through the laryngeal mask airway without gastric distension.