Safety and clinical usefulness of supraglottic airway device

Abstract

Supraglottic airway devices (SADs) are used to keep the upper airway open and provide adequate ventilation and oxygenation. Their use is increasing, and various kinds of SADs have been introduced to routine clinical practice. This review describes the characteristics and illustrates the use of those SADs that have been introduced to and/or are available in Korea. Particular attention is paid to the use of SADs in special clinical settings such as a difficult airway, prehospital care, resuscitation, and intubation. There has been a paradigm shift in the emphasis of difficult airway management from endotracheal intubation to adequate ventilation and oxygenation. SADs have proven to be useful alternatives to tracheal intubation; however, they also have potential disadvantages such as the risk of regurgitation of gastric contents and pulmonary aspiration. Advances in SAD design such as drainage tubes or double cuffs, which lessen the possibility of harmful events and complications, are discussed. The evolution and widespread use of SADs have changed the clinical theory and practice of airway management. Clinicians should be aware of the strengths and limitation of each SAD and understand the limited evidence currently available for guidance.