Apr 3, 2012

Impairment of carotid artery blood flow by supraglottic airway use in a swine model of cardiac arrest

Nicolas SegalDavid G Chase


Supraglottic airway devices (SGDs) are often used as an alternative to endotracheal tube (ETT) during cardiopulmonary resuscitation (CPR). SGDs can be inserted 'blindly' and rapidly, without stopping compressions. These devices utilize pressurized balloons to direct air to the trachea and prevent esophagus insufflation. We hypothesize that the use of a SGD will compress the carotid artery and decrease carotid blood flow (CBF) during CPR in pigs. Ventricular fibrillation (VF) was induced in 9 female pigs (32 ± 1 kg) followed by 4 min without compressions. CPR was then performed continuously for 3-6-min intervals. During each interval, an ETT was used for the first 3 min, followed by 3 min of each SGD (King LTS-D™, LMA Flexible™, Combitube™) in a random order. The primary endpoint was mean CBF (ml/min). Statistical comparisons among the 4 airway devices were performed by Wilcoxon Rank test. Post mortem carotid arteriographies were performed with SGDs in place. CBF (median ml/min; 25/75 percentile) was significantly lower with each SGD [King (10; 6/41), LMA (10; 4/39), and Combitube (5; -0.4/15)] versus ETT (21; 14/46) (p<0.05 for each SGD compared with ETT). Arteriograms showed that with each SGD there was compression of the inte...Continue Reading

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Mentioned in this Paper

Ventricular Fibrillation
Esophageal Tissue
Plain X-ray
Common Carotid Artery
Entire Carotid Artery
Esophageal Diseases
Basic Cardiac Life Support

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