• Bertram Scheller, Richard Schalk, Christian Byhahn, Norman Peter, Nanette L'Allemand, Paul Kessler, and Dirk Meininger.
• Department of Anaesthesiology, Intensive Care Medicine and Pain Management, Goethe-University Medical School, Frankfurt/Main, Germany. scheller@em.uni-frankfurt.de
• Resuscitation. 2009 Jul 1;80(7):805-10.

ObjectiveDifficult paediatric airways, both expected and unexpected, present major challenges to every anaesthesiologist, paediatrician and emergency physician. However, the integration of supraglottic airway devices, such as the laryngeal mask (LM), into the algorithm of difficult airways has improved the handling of difficult airway situations in patients. A recent device for establishing a supraglottic airway is the laryngeal tube, introduced in 1999. We report on the successful use of the laryngeal tube suction II (LTS II) in securing the airway when endotracheal intubation or alternative mask ventilation has failed.MethodsThe use of the LTS II in 10 cases of difficult airway management in neonates and infants <6 months was reviewed.ResultsUse of the LTS II was associated with a high level of success (100%), often rescuing the airway when other techniques had failed. All insertions were successful on first attempt using a modified insertion technique. Placement was classified as "easy" by all users.ConclusionsThe potential advantage of the LTS II is the suction port which allows gastric tube placement and subsequent egression of gastric contents. In emergency situations when direct laryngoscopy fails, or is too time-consuming because of anatomical abnormalities, we recommend the LTS II tube as the first-line device to secure the airway. As with all supraglottic airways, familiarity and clinical experience with the respective device and its insertion technique is essential for safe and successful use, especially in emergencies.

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