Page 571 - Hall et al (2015) Principles of Critical Care-McGraw-Hill

CHAPTER 45: Airway Management 391

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A LMA Classic Airway B LMA ProSeal Airway
15 mm connector
15 mm connector
Airway tube

Drain tube
Airway tube Bite block
Inflation pilot ballon

Inflation line Inflation line

Inflation pilot balloon
Manual vent
Valve Cuff

Aperture bars
Cuff
Drain tube opening
C LMA Fastrach ® Airway

ETT adaptor

Inflation line
15 mm connector

Inflation pilot
balloon
Handle

Valve

Epiglottic elevating bar Airway tube
FIGURE 45-2. A. Classic laryngeal mask airway is available in eight sizes (1, 1½, 2, 2½, 3, 4, 5, and 6) that can be used in patients ranging from neonates to large adults. Its role in difficult
or failed face mask ventilation is well established, and it has multiple applications in the American Society of Anesthesiologists’ Practice Guidelines for Management of the Difficult Airway algo-
rithm published in 1993 and revised in 2013. B. LMA-ProSeal™ is an advanced version of the classic LMA with more airway management options. It provides higher seal pressure and therefore
is more suitable for positive pressure ventilation. The drain tube communicates with the upper esophagus and permits passage of a nasogastric tube and decompression of the stomach, which
is very valuable in patients with failed intubation and a distended stomach. C. Intubating LMA (Fastrach™) is available in sizes 3, 4, and 5, and is designed to facilitate tracheal intubation with
endotracheal tubes up to 8-mm inside diameter. Intubation can be performed blindly or in case of difficulty with the help of flexible bronchoscopy. Like the classic LMA, the Fastrach™ establishes
ventilation when face mask ventilation has failed, and permits oxygenation and ventilation during intubation, which is useful when large amounts of secretions and blood are present in the
airway following failed intubation attempts. (Courtesy of LMA North America, Inc.)

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