Comparison of Supreme(®) and Soft Seal(®) laryngeal masks for airway management during cardiopulmonary resuscitation in novice doctors: a manikin study.

ABSTRACT

PURPOSE: In the 2005 American Heart Association (AHA) guidelines, the laryngeal mask (LMA) was proposed as an alternative to tracheal intubation for cardiopulmonary resuscitation (CPR). We compared the utility of a newly developed LMA, the Supreme(®) (Supreme), with a conventional LMA, the Soft Seal(®) (Soft Seal). METHODS: A total of 19 novice doctors in our anesthesia department performed insertion of the Supreme or Soft Seal on a manikin with or without chest compression. Insertion time and number of attempts for successful ventilation were measured. After successful ventilation, the amount of air entering the stomach and maximum ventilation pressure were measured. The subjective difficulty of using the devices was also measured. RESULTS: The ventilation success rate of first insertion did not differ between the Supreme and Soft Seal without chest compression. However, the success rate was significantly lower with the Soft Seal than the Supreme during chest compression. Insertion time was lengthened by chest compression with the Soft Seal, but not with the Supreme. Maximum ventilation pressure was higher with the Supreme than the Soft Seal. The amount of air entering the stomach was significantly lower with the Supreme than the Soft Seal. The Supreme also scored better than the Soft Seal on a visual analog scale of subjective difficulty in insertion. CONCLUSIONS: The Supreme is an effective device for airway management during chest compression.