Table 6. Supraglottic Ventilatory Devices |
Name (manufacturer) | Description | Size | Clinical applications | Special features |
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AES Ultra (AES) | All-silicone laryngeal mask with standard cuff valve. | Adult sizes 3-6. | Standard all-silicone SGA. | All silicone. Single use. |
AES Ultra Clear (AES) | Silicone cuff and PVC tube, laryngeal mask with standard cuff valve. | Adult sizes 3-6. | Combines all-silicone cuff with PVC tube for cost savings. | All-silicone cuff with PVC tube. Single use. |
AES Ultra EX (AES) | All-silicone, multiple-use laryngeal mask. | Pediatric to adult sizes 1-6. | Reusable, standard SGA. | 40 uses. |
AES Ultra Flex EX (AES) | All-silicone, wire-reinforced, multiple-use laryngeal mask. | Pediatric to adult sizes 1-6. | Reusable, wire-reinforced SGA, designed to accommodate repositioning of the head and neck during surgery. | 40 uses. |
Air-Q3 (Cookgas/SunMed) | Hypercurved all-silicone intubating laryngeal airway that resists kinking and has removable airway connector. Anterior portion of mask is recessed; larger mask cavity allows intubation using standard ETTs. Air-Q3 removal after intubation is accomplished by using air-Q reusable removal stylet. | Sizes (0, 0.5, 1.0, 1.5, 2.0, 3.0, 4.0, 5.0) that can accommodate standard ETTs size 4.0-9.0 mm. | Allows easy access for FIS devices. Use as routine laryngeal mask airway. Removable connector allows intubation with standardETTs =8.5 mm. | All silicone, designed to minimize folding of cuff tip on insertion. Integrated bite block reinforces the tube while decreasing need for a separate bite block. Color-coded removable connectors tethered to the airway tube, avoiding episodes of misplaced connectors. |
Air-Q3G (Cookgas/SunMed) | Combines the features of Air-Q3 laryngeal mask, with the addition of dual gastric channels. These channels provide access to the esophagus with an NGT or allows the clinician to apply suction to one of the channels, and create a circle (or sump) drain at the distal tip in the esophagus. | Sizes (0, 0.5, 1.0, 1.5, 2.0, 3.0, 4.0, 5.0) that can accommodate standard ETTs size 4.0-9.0 mm. | Enhanced version of the standard Air-Q3. Indicated as primary airway device when oral ETT is not necessary or as aid to intubation in difficult situations. | All-silicone design with the same features as the Air-Q3 above. The dual gastric channels are especially suited for suction catheters and NGTs up to size 18.0 Fr. |
air-Q Disposable (Cookgas) | Hypercurved intubating laryngeal airway with removable color-coded connectors. Anterior portion of mask is recessed; larger mask cavity allows intubation using standard ETTs. Removal of air-Q after intubation is accomplished by using air-Q reusable removal stylet. | Sizes (1.0, 1.5, 2.0, 2.5, 3.5, 4.5) that can accommodate standard ETTs =8.5 mm. | More secure than a face mask and less invasive than intubation with an ETT when tracheal intubation is not necessary or during unexpected difficult airway situation. | Removable color-coded connector allows intubation with standard ETTs =8.5 mm. |
Air-Q3SP (Cookgas/SunMed) | Combines features of the Air-Q3 with added advantage of a self-pressurizing mask. No inflation line or pilot balloon is needed. PPV or spontaneously breathing patients inflate the mask during the uptake of ventilation. | Sizes (0, 0.5, 1.0, 1.5, 2.0, 3.0, 4.0, 5.0) that can accommodate standard ETTs 4.0-9.0 mm. | More secure than a face mask and less invasive than intubation with an ETT when tracheal intubation is not necessary or during unexpected difficult airway situation. | Incorporates the Air-Q3 design with self-inflating mask. |
Air-Q3SPG (Cookgas/SunMed) | Combines features of the Air-Q3G with dual gastric channels and with added advantage of a self-pressurizing mask. No inflation line or pilot balloon is needed. PPV or spontaneously breathing patients inflate the mask during the uptake of ventilation. | Sizes (0, 0.5, 1.0, 1.5, 2.0, 3.0, 4.0, 5.0) that can accommodate standard ETTs 4.0-9.0 mm. | Same as regular Air-Q3G but eliminates need for mask inflation. | PPV self-pressurizes mask cuff. On exhalation, mask cuff decompresses to level of PEEP. Removable connector allows intubation with standard ETTs. The dual gastric channels are especially suited for suction catheters and NGTs up to size 18.0 Fr. |
Aura40 (Ambu) | Same design as the Ambu AuraOnce, but reusable. | Pediatric to adult sizes 1-6. | Routine use of SGA. | Reusable. |
Aura40 Straight (Ambu) | Same design as the Ambu AuraStraight, but reusable. | Pediatric to adult sizes 1-6. | Routine use of SGA. | Reusable. Available only in US. |
AuraFlex (Ambu) | Disposable wire-reinforced flexible laryngeal mask. | Pediatric to adult sizes 2-6. | Designed for use in ENT, ophthalmic, dental and torso surgeries. | Integrated pilot tube and high flexibility enables positioning away from the surgical field, without loss of seal. Single use. EasyGlide texture and extra-soft cuff ease insertion and removal. Convenient depth marks for monitoring correct position of the mask. |
AuraGain (Ambu) | Second-generation laryngeal mask, featuring anatomic curve for rapid placement, gastric access for suction and decompression of the stomach via a gastric tube, and integrated direct intubation capability for management of expected or unexpected difficult airway. | Pediatric to adult sizes 1-6. | Useful for ventilation and intubation. Appropriate for management of expected or unexpected difficult airway. | Allowable ETT size is designated on each device; maximum OG tube size is also included (e.g., 16 Fr for sizes 3-6). A soft, bite absorption area is integrated into the device as is a pilot fixator. Pediatric sizes 1 and 1.5 feature an innovative connector that reduces dead space by 39%. |
Aura-i (Ambu) | A laryngeal mask with built-in curve and bite blocker designed as a conduit for optical tracheal intubation. | Pediatric to adult sizes 1-6. | Combines everyday routine use of SGA with direct intubation capability in case of difficult airway situations. | Anatomically correct curve designed as Ambu AuraOnce and Ambu Aura40 but specially designed as a conduit for intubation. Compatible with standard ETTs. |
AuraOnce (Ambu) | A laryngeal mask with a special built-in curve that replicates natural human anatomy. It is molded in one piece with an integrated inflation line and no epiglottic bars on the anterior surface of the cuff. | Pediatric to adult sizes 1-6. | Allows easy access for FIS devices. For use in both anesthesia and emergency medicine. | Anatomically correct curve facilitates placement. One-piece mold. EasyGlide texture for ease of insertion. Convenient depth marks for monitoring correct position of the mask. MRI safe. Extra-soft cuff. If intubation is necessary or desired, recommend intubation over Aintree AEC. Single use. |
AuraStraight (Ambu) | A straight laryngeal mask featuring a single-mold design and an extra-soft, thin cuff which easily conforms to the airway. | Pediatric to adult sizes 1-6. | For use in both anesthesia and emergency medicine. | Single-use, one-piece mold. EasyGlide texture for ease of insertion. Convenient depth marks for monitoring correct position of the mask. MRI safe. Extra-soft cuff. |
Flexi 2G SAD (Genesis Airway Innovations) | A second-generation, single-use, flexible laryngeal mask airway with a sliding bite block. Wide-bore, wire-reinforced silicone gastric drainage channel allows drainage of large volumes of fluid and easy insertion of a large-bore OG tube. Introducer converts SGA into anatomically curved SGA for insertion into larynx. | Sizes 3-5. | For use in situations where a flexible SGA is required for surgical access and the use of a first-generation flexible SGA is unsuitable (see NAP4 guidelines). May be used in any situation where an SGA is required. | Single-use, wide-bore, reinforced silicone gastric channel, introducer converts the flexible SGA into an anatomically curved SGA for insertion and prevents rotation and folding over of the mask in the larynx. Sliding bite block gives versatility to positioning of the airway and gastric tubes. Can be exchanged for an ETT using the Aintree AEC. |
i-gel (Intersurgical) | A second-generation, single-use SGA with a non-inflating cuff, designed to mirror the perilaryngeal anatomy, with an integral bite block, buccal cavity stabilizer and gastric channel. Also incorporates wide-bore airway channel to aid insertion and eliminate the potential for rotation. Can be used as a conduit for intubation under fiber-optic guidance (sizes 3-5). | Adult sizes 3-5 and pediatric sizes 1-2.5; adult sizes accommodate ETTs 6.0-8.0 mm. | For use in routine and emergency anesthesia and resuscitation in adult patients. Can be used as a conduit for intubation under fiber-optic guidance (sizes 3-5). Gastric channel provides early warning of regurgitation, allows for passing of a GT to empty stomach contents and facilitate venting (except size 1). | Single-use, non-inflating cuff allows easy and rapid insertion, provides high seal pressures, and minimizes risk for tissue compression. Gastric channel provides early warning of regurgitation. Buccal cavity stabilizer reduces risk for rotation or displacement, and integral bite block prevents occlusion of airway channel. Wide-bore airway channel also allows for use as a conduit for intubation with flexible scope guidance (sizes 3-5). |
i-gel O2 Resus Pack (Intersurgical) | A second-generation, single-use SGA with a supplementary O2 port designed to facilitate ventilation during CCR. A color-coded hook ring is used to secure the airway support strap and aids in size identification. Non-inflating cuff that mirrors the perilaryngeal anatomy, with an integral bite block, buccal cavity stabilizer and gastric channel. The pack contains an i-gel O2, a sachet of lubricant and an airway support strap. | Adult sizes 3-5; adult sizes accommodate ETTs 6.0-8.0 mm. | For use in routine and emergency anesthesia and resuscitation in adult patients. Can be used as a conduit for intubation under fiber-optic guidance. i-gel O2 also can be used to provide supplementary O2 during postoperative care or patient transfer. Gastric channel provides early warning of regurgitation, allows for passing of GT to empty stomach contents and facilitate venting. | Single-use, non-inflating cuff allows easy and rapid insertion, provides high seal pressure and minimizes risk for tissue compression. A supplementary O2 port allows for administration of passive oxygenation as a component of CCR. Gastric channel provides early warning of regurgitation. Buccal cavity stabilizer reduces risk for rotation or displacement and integral bite block prevents occlusion of airway channel. |
KING LT-D (Ambu) | Disposable, single-lumen tube with two low-pressure cuffs. Intended for insertion into upper esophagus with ventilatory openings aligned with tracheal inlet; distal cuff seals the esophagus and the proximal cuff seals the oropharynx. | Adult sizes 3-5 and pediatric sizes 2, 2.5. | Useful for routine or emergency airway management. Two cuffs provide elevated ventilatory seal; esophageal cuff provides physical barrier in esophagus, reducing gastric insufflation and providing potential aspiration protection. Commonly used in EMS. | Both cuffs are inflated with a single pilot tube/valve; printed depth marks; color-coded 15-mm connectors for each size. Also available in a compact, vacuum-sealed kit with inflation syringe and lube. |
KING LTS-D (Ambu) | Disposable double-lumen LT with separate ventilation and gastric access channels. Intended for insertion into upper esophagus with ventilatory openings aligned with the tracheal Inlet; distal cuff seals the esophagus and the proximal cuff seals the oropharynx. | Adult sizes 3-5 and pediatric sizes 0, 1, 2, 2.5. | Useful for routine or emergency airway management. Two cuffs provide elevated ventilatory seal; esophageal cuff provides physical barrier in esophagus, reducing gastric insufflation and providing potential aspiration protection. Separate gastric access channel allows venting and active removal of gastric fluids. Commonly used in EMS. | Both cuffs are inflated with a single pilot tube/valve; printed depth marks; color-coded 15-mm connectors for each size. Large gastric port (sizes 3-5 allow 18 Fr OG tube passage). Also available in a compact, vacuum-sealed kit with inflation syringe and lube. |
LarySeal Pro (Flexicare) | Next-generation SGA with integrated suction, reinforced bite guard, preformed anatomic curve and ETT insertion capabilities. | Adult sizes 3-5 and pediatric sizes 1, 1.5, 2, 2.5. | Rapid and secure management for any airway. Equipped with features for difficult airways. | Large channel for improved suction. Guide system for directed ETT insertion. Epiglottic fenestrated flap prevents blockage and elevates the epiglottis for ETT or FIS insertion. |
LMA Classic (Teleflex) | General-purpose airway for routine elective inpatient and outpatient surgical procedures. | Adult sizes 3-6 and pediatric sizes 1, 1.5, 2, 2.5. | Although originally developed for airway management of routine cases with spontaneous ventilation, it is now listed in the ASA Difficult Airway Algorithm as an airway ventilatory device or a conduit for tracheal intubation. Can be used in pediatric and adult patients in whom ventilation with a face mask or intubation is difficult or impossible. Also can be used as bridge to extubation and with pressure support or PPV. | Aperture bars designed to prevent blockage of the airway by he epiglottis. Reusable up to 40 times. Silicone cuff. Not made with natural rubber latex. |
LMA Fastrach (Teleflex) | Designed to facilitate blind intubation without moving head or neck, allowing for single-handed insertion. Allows continuous ventilation between intubation attempts. | Adult sizes 3-5 that can accommodate special ETTs 6.0-8.0 mm. | Designed for anatomically difficult airway and included in AHA’s and ASA’s difficult airway algorithms. | Supplied as either a sterile version for single-use only, or as a reusable version that may be used =40 times. Silicone cuff. Not made with natural rubber latex. |
LMA Flexible (Teleflex) | Has a reinforced airway tube that allows it to be positioned away from the surgical field while maintaining a good seal. | Adult sizes 3-6 and pediatric sizes 2, 2.5. | Ideal for ENT, ophthalmic and dental surgery, or other procedures where the surgeon and anesthesiologist compete for airway access. | Supplied as either a sterile version for single use only, or as a reusable version that may be used =40 times. Not made with natural rubber latex. |
LMA Gastro with Cuff Pilot (Teleflex) | LMA specifically designed to give clinicians control of their patients’ airways while facilitating direct endoscopic access via the integrated endoscope channel. Once placed, the LMA Gastro Airway facilitates ETCO2 monitoring throughout the procedure to support patient safety. | Adult sizes 3-5. | Designed to provide control of a patient’s airway while enabling direct access to the esophagus and upper gastrointestinal tract in adult patients undergoing endoscopic procedures. | Endoscope channel enables an endoscope (max OD, 14 mm) to be passed through the device under vision. Cuff Pilot Technology, an integrated cuff pressure indicator that provides constant at-a-glance feedback, alerting clinicians to changes in cuff pressure. Integral bite block reduces the potential for damage to, or obstruction of, the airway tube or endoscope due to biting. Adjustable holder and strap maintain the device in a neutral position during endoscope manipulation. |
LMA ProSeal (Teleflex) | Double-cuff design enables seal pressures of =30 cm H2O, and the drain tube separates the alimentary and respiratory tracts. | Adult sizes 3-5 and pediatric sizes 1, 1.5, 2, 2.5. | Drain tube higher seal pressures along with the flexible airway tube enable longer periods of ventilation with minimal posterior pharyngeal wall damage, therefore expanding the types of procedures in which an LMA can be used. | Second cuff allows tighter seal for PPV. Silicone cuff. Reusable up to 40 times. Not made with natural rubber latex. |
LMA Protector with Cuff Pilot (Teleflex) | Second-generation SGA with silicone cuff designed to achieve an oropharyngeal seal equivalent to the LMA ProSeal Airway (>30 cm H2O). Combines a pharyngeal chamber and dual gastric drainage channels, designed specifically to minimize gastric insufflation and facilitate gastric access. | Adult sizes 3-5. | For routine procedures or to manage high-risk patients. | Elongated, inflatable silicone cuff is designed to conform to the contours of the hypopharynx and achieve an oropharyngeal seal equivalent to the LMA ProSeal Airway (>30 cm H2O). The esophageal seal secures the distal tip at the upper esophageal sphincter and is designed to minimize gastric insufflation and facilitate gastric access. The airway tube allows for direct flexible scope–aided intubation with ETTs up to 7.5 mm. |
LMA Supreme (Teleflex) | Combines features of previous LMAs to provide increased safety and ease of use. The higher seal pressure and gastric access provide a higher degree of safety. Designed to channel fluids away from the airway in the unlikely event of active or passive regurgitation and allows for diagnostic positioning. | Adult sizes 3-5 and pediatric sizes 1, 1.5, 2, 2.5. | For routine procedures or to manage higher-risk patients. | Allows for easy insertion, higher seal pressures, and provides gastric access to suction or decompress the stomach. First Seal Technology is designed to provide adequacy of gas exchange. Second Seal Technology is designed to reduce risk for insufflation during ventilation. Designed to provide a passive conduit for unexpected regurgitation. The angle of the LMA Supreme Airway facilitates ease of insertion in various head positions. |
LMA Unique (Teleflex) | Original, single-use LMA with design based on LMA Classic. Available with or without syringe and lubricant. | Adult sizes 3-5 and pediatric sizes 1, 1.5, 2, 2.5. | Same as LMA Classic. Included in AHA 2000 Guidelines for CPR and Emergency Medicine Cardiovascular Care. | Aperture bars designed to prevent the blockage of airflow by the epiglottis. Single use. Sterile. Not made with natural rubber latex. |
LMA Unique EVO with Cuff Pilot (Teleflex) | First-generation, silicone cuffed LMA that offers ETT intubation capabilities. | Adult sizes 3-5. | Enhanced design is ideal for unforeseen airway complications where intubation becomes necessary, and the silicone cuff is designed to be gentle to the anatomy. | Also features Cuff Pilot Technology, an integrated cuff pressure indicator that provides constant at-a-glance feedback, alerting clinicians to changes in cuff pressure. Single use. Sterile. Not made with natural rubber latex. MRI safe. |
LMA Unique with Cuff Pilot (Teleflex) | A versatile, single-use, first-generation laryngeal mask with a medical-grade silicone cuff and integrated cuff pressure manometer. | Adult sizes 3-6 and pediatric sizes 1, 1.5, 2, 2.5. | The LMA Unique Airway is an ideal choice for routine anesthetic procedures, for difficult airway situations, or for airway management during cardiopulmonary resuscitation. | Silicone cuff is soft and flexible and conforms to the anatomy to create an effective oropharyngeal seal. Aperture bars designed to prevent the blockage of airflow by the epiglottis. Cuff Pilot Technology, an integrated cuff pressure indicator that provides constant at-a-glance feedback, alerting clinicians to changes in cuff pressure. Single use. Sterile. Not made with natural rubber latex. MRI safe. |
Portex Clear PVC, Oral/Nasal, Soft Seal Cuff Tracheal Tubes (Smiths Medical) | Similar in shape to the first-generation laryngeal mask, but differs in its one-piece design, in which the cuff is softer and there is no “step” between the tube and the cuff, an integrated inflation line, no epiglottic bars on the anterior surface of the cuff and a wider ventilation orifice. | Pediatric to adult sizes 1-5. | Allows easy access for flexible scope devices. | If intubation necessary or desired, will accommodate ETT up to 7.5 mm. Single use. |
Shiley (Medtronic) | A disposable, cost-effective laryngeal mask airway with integrated cuff inflation line. Designed to form a low-pressure seal around the laryngeal inlet and maintain a secure airway. | Pediatric to adult sizes 1-6. | Suitable for spontaneous, assisted or controlled ventilation during routine and emergency anesthetic procedures. | Single-use, disposable, contoured tube soft cuff with integrated cuff inflation line. |
Shiley Esophageal Endotracheal Airway, Double Lumen (Medtronic) | A disposable DLT that combines the features of a conventional ETT with those of an esophageal obturator airway. Has a large proximal latex oropharyngeal balloon and a distal esophageal low-pressure cuff with eight ventilatory holes in between. | Two adult sizes: 41 Fr, height >5 ft; 37 Fr, height 4-6 ft. | Routine use of SGA but not contraindicated in non-fasting patients. Appropriate for prehospital, intraoperative and emergency use. Especially useful for patients in whom direct visualization of vocal cords is not possible, patients with massive airway bleeding or regurgitation, limited access to airway and patients in whom neck movement is contraindicated. | Ventilation possible with either tracheal or esophageal intubation. Distal cuff seals off the esophagus to prevent aspiration of gastric contents. Allows passage of an OG tube when placed in the esophagus. Single use. |
Soft-Seal (Smiths Medical) | Similar in shape to the first-generation laryngeal mask, but differs in its one-piece design, in which the cuff is softer and there is no “step” between the tube and the cuff, an integrated inflation line, no epiglottic bars on the anterior surface of the cuff and a wider ventilation orifice. | Pediatric to adult sizes 1-5. | Allows easy access for flexible scope devices. | If intubation necessary or desired, will accommodate ETT up to 7.5 mm. Single use. |
Solus Curve (Intersurgical) | A single-use SGA designed for those who prefer the insertion characteristics of a curved device. Includes a classic cuff shape, integral inflation line and a high-quality valve. | Adult sizes 3-5. | For use in anesthesia and emergency medicine. Single-use SGAs are latex free and supplied sterile. | Features a curved airway tube. Classic cuff shape provides optimum anatomic conformance with a firm, smooth-surfaced back plate to aid ease of insertion. Essential information, such as device size, is prominently displayed at the top of the tube and on the pilot balloon for quick visual reference. Not made with natural rubber latex. |
Solus Flexible (Intersurgical) | A range of single-use SGA with a wire-reinforced tube, permits flexion without kinking and can be moved at any time mid-procedure without concern for the cessation of gas flow. Includes a classic cuff shape, integral inflation line and a high-quality valve. | Adult sizes 3-5 and pediatric sizes 2, 2.5. | For use in anesthesia and emergency medicine. An ideal solution for airway management in procedures such as ENT, dental, oromaxillary and eye surgery where the rigidity of airway devices can obscure surgical access. | Classic cuff shape provides optimum anatomic conformance with a firm, smooth-surfaced back plate to aid ease of insertion. Essential information, such as device size, is prominently displayed at the top of the tube and on the pilot balloon for quick visual reference. Not made with natural rubber latex. |
Solus MRI Safe (Intersurgical) | A range of single-use SGA fitted with specially tested nonferrous valves, guaran-teed not to interfere with the magnet in an MRI scanner. The plastic valve ensures full reliability throughout the shelf life of each device. | Adult sizes 3-5 and pediatric sizes 1, 1.5, 2, 2.5. | For use in anesthesia and emergency medicine. Single-use SGAs are latex free and supplied sterile. | Same as Solus Flexible. MRI safe. |
Solus Satin (Intersurgical) | A range of single-use SGA with a softer airway tube providing Increased flexibility. Provides a classic cuff shape, an integral inflation line and a high-quality valve to ensure continual cuff integrity. | Adult sizes 3-5. | For use in anesthesia and emergency medicine. Single-use SGAs are latex free and supplied sterile. | Same as Solus Flexible. |
Solus Standard (Intersurgical) | A range of single-use SGA featuring a low-friction material, classic cuff shape, integral inflation line and a high-quality valve. | Adult sizes 3-5 and pediatric sizes 1, 1.5, 2, 2.5. | For use in anesthesia and emergency medicine. Single-use SGAs are latex free and supplied sterile. | Same as Solus Flexible. |