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The following is a summary of “A Prospective Crossover Study Comparing Six Current Generation Supraglottic Airway Device’s Ability to Seal During CPR in Human Cadavers,” published in the February 2025 issue of Emergency Medicine by Holley et al. 

Supraglottic airway (SGA) devices are commonly used during cardiopulmonary respiration (CPR), but effectiveness in maintaining a reliable airway seal remains unclear.  

Researchers conducted a retrospective study to compare intrathoracic pressures (ITPs) generated during automated CPR (aCPR) using an impedance threshold device (ZOLL Medical Corporation, Chelmsford, MA) with 6 SGA devices vs a standard endotracheal tube (ETT).  

They measured airway pressures and negative ITPs in 6 recently deceased human cadavers with different body habitus. Following the placement of an ETT and 6 distinct SGAs devices and evaluated airway pressures and ITPs during aCPR and manual positive pressure ventilation using a bag-valve mask. The ETT, serving as the control for airway sealing, was placed first, followed sequentially by each SGA. The primary outcome involved comparing airway pressures and ITPs across all groups.  

The results showed that SGAs devices demonstrated varying abilities to generate negative airway pressures and ITPs. Data were collected from 6 human cadavers. Airway pressures and negative ITPs were recorded during CPR using an impedance threshold device in conjunction with an ETT, King LTS-D, LMA-S, i-gel, Air-Qsp3G, AuraGain, and Air-Qsp during aCPR.  The variability in airway and ITP generation across the devices was also observed. The ETT produced the highest median negative ITP values and SGAs exhibited more significant variability in negative ITP generation.  

Investigators concluded the ability to generate negative ITP varied with different SGAs during active CPR with an impedance threshold device in the human cadaver. 

Source: sciencedirect.com/science/article/abs/pii/S073646792400266X