Video laryngeal masks in airway management

ABSTRACT

Introduction

Video laryngeal masks have become alternatives to classical supraglottic airway devices in recent years. This review provides information on the background of these new medical devices, the most popular and widely used video laryngeal masks, their advantages, disadvantages and their main applications in airway management.

Areas covered

In this review, the physical differences between video laryngeal masks and second-generation laryngeal mask airways, and their properties in specific clinical settings are discussed.

Expert Commentary

To limit airway-related morbidity, an optimal position of supraglottic airway devices must be the primary goal. Extensive research has shown that blindly inserted laryngeal mask can be malpositioned in 50% to 80% of the cases. Therefore, blind insertion should be the exception rather than the rule unlike current practice. Video laryngeal mask airways have clear advantages in routine use and in difficult airway management since they allow a vision-guided technique. Henceforth, the properties perceived in clinical practice must be endorsed with quality clinical evidence.

KEYWORDS:

• Airway management
• laryngeal masks airways
• videolaryngoscopy
• endotracheal intubation
• optical devices
• safety management
• economics

Article highlights

• Video laryngeal masks (VLMs) are the latest evolution of supraglottic airways. Their vision-guided insertion could improve their placement and thus avoid the incidence of malposition.

• These devices allow tracheal intubation without fiberoptic assistance; therefore, they could be advantageous as a rescue device in locations where a fiberoptic bronchoscope is not available and in situations where there is not enough time.

• VLMs provide continuous oxygenation-guided intubation which is particularly advantageous in patients with poor preoperative pulmonary reserve.

• Further evaluation is necessary to confirm their precise role in the airway armamentarium.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.