Sharma Bimla, Sahai Chand, Sood Jayashree
Department of Anaesthesiology, Pain and Perioperative Medicine, Sir Ganga Ram Hospital, New Delhi, India.
Med Devices (Auckl). 2017 Aug 17;10:189-205. doi: 10.2147/MDER.S110186. eCollection 2017.
Extraglottic airway devices (EADs) have revolutionized the field of airway management. The invention of the laryngeal mask airway was a game changer, and since then, there have been several innovations to improve the EADs in design, functionality, safety and construction material. These have ranged from changes in the shape of the mask, number of cuffs and material used, like rubber, polyvinylchloride and latex. Phthalates, which were added to the construction material in order to increase device flexibility, were later omitted when this chemical was found to have serious adverse reproductive outcomes. The various designs brought out by numerous companies manufacturing EADs resulted in the addition of several devices to the airway market. These airway devices were put to use, many of them with inadequate or no evidence base regarding their efficacy and safety. To reduce the possibility of compromising the safety of the patient, the Difficult Airway Society (DAS) formed the Airway Device Evaluation Project Team (ADEPT) to strengthen the evidence base for airway equipment and vet the new extraglottic devices. A preuse careful analysis of the design and structure may help in better understanding of the functionality of a particular device. In the meantime, the search for the ideal EAD continues.
声门外气道装置(EADs)彻底改变了气道管理领域。喉罩气道的发明是一个重大变革,从那时起,在设计、功能、安全性和建筑材料方面有了多项创新来改进EADs。这些创新包括面罩形状、套囊数量和所用材料(如橡胶、聚氯乙烯和乳胶)的变化。邻苯二甲酸盐被添加到建筑材料中以增加装置的柔韧性,但后来发现这种化学物质会产生严重的不良生殖后果,便被摒弃。众多生产EADs的公司推出的各种设计使得气道市场增加了多种装置。这些气道装置投入使用,其中许多在疗效和安全性方面缺乏充分的证据或根本没有证据。为降低危及患者安全的可能性,困难气道协会(DAS)成立了气道装置评估项目团队(ADEPT),以加强气道设备的证据基础并审查新的声门外装置。使用前对设计和结构进行仔细分析可能有助于更好地了解特定装置的功能。与此同时,对理想的EAD的探索仍在继续。