• Ron O Abrons, Patrick Ten Eyck, and Isaac D Sheffield.
• Associate Professor, Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, IA, USA. Ron-abrons@uiowa.edu.
• BMC Anesthesiol. 2021 Mar 29; 21 (1): 94.

BackgroundOropharyngeal airways are used both to facilitate airway patency during mask ventilation as well as conduits for flexible scope intubation, though none excel at both. A novel device, the Articulated Oral Airway (AOA), is designed to facilitate flexible scope intubation by active displacement of the tongue. Whether this active tongue displacement also facilitates mask ventilation, thus adding dual functionality, is unknown. This study compared the AOA to the Guedel Oral Airway (GOA) in regards to efficacy of mask ventilation of patients with factors predictive of difficult mask ventilation. The hypothesis was that the AOA would be non-inferior to the GOA in terms of expiratory tidal volumes by a margin of 1 ml/kg, thus demonstrating dual functionality.MethodsIn this randomized controlled clinical trial, fifty-eight patients with factors predictive of difficult mask ventilation were mask ventilated with both the GOA and the AOA. Video of the anesthetic monitors were evaluated by a blinded member of the research team, noting inspiratory and expiratory tidal volumes and expiratory CO2 waveforms.ResultsThe AOA was found to be non-inferior to the GOA at a margin of 1 ml/kg with a mean weight-standardized expiratory tidal measurement 0.45 ml/kg lower (CI: 0.34-0.57) and inspiratory tidal measurement 0.109 lower (CI: - 0.26-0.04). There was no significant difference in expiratory waveforms (p = 0.2639).ConclusionsThe AOA was non-inferior to the GOA for mask ventilation of patients with predictors of difficult mask ventilation and there was no significant difference in EtCO2 waveforms between the groups. These results were consistent in the subset of patients who were initially difficult to mask ventilate.Trial RegistrationClinicalTrials.gov, NCT03144089 , May 2017.

14 keywords...

hide…