The Supreme Laryngeal Mask Airway™ (LMA): A new neonatal supraglottic device: Comparison with Classic and ProSeal LMA in a manikin

Aim: The study aims to compare the performances (ease of insertion, time to establish effective ventilation and maximal inflation pressure) of classic (TM) (cLMA), ProSeal (TM) (PLMA) and Supreme (TM) (SLMA) Laryngeal Mask Airway when used in a neonatal airway management manikin by inexperienced delivery room trainees. The quality of the three devices, as perceived by participants, was also evaluated. Methods: Health-care professional trainees were given a brief supervised training with the three devices. Every trainee was then observed positioning each of the three different LMAs in a single occasion. Success rate, time (IT) and maximal inflation pressure (PImax) were recorded by a single unblinded observer. A 4-point scale was used to rate participants' perceived quality. Results: A total of 40 health-care professional trainees participated in the study. There were five, three and one failed insertions at the first attempt with the cLMA, PLMA and SLMA, respectively. No failures to establish an effective airway within three attempts were recorded. The success rate at first attempt was comparable among the three devices. The mean IT was significantly lower with the SLMA as compared with PLMA (p < 0.01), but not to cLMA. The mean PImax was higher with SLMA than with cLMA and PLMA (p < 0.01). The ease of insertion as well as the effectiveness of ventilation were perceived by the participants as superior with SLMA as compared with cLMA and PLMA (p < 0.01). Conclusions: Neonatal SLMA is superior to PLMA in terms of time to establish effective ventilation; furthermore, maximal inflation pressure and quality perceived by the operator are higher with neonatal SLMA than with cLMA and PLMA. These manikin data could provide a useful guide for planning potential future clinical research involving the newly developed supraglottic device in neonates. (C) 2011 Elsevier Ireland Ltd. All rights reserved.