Ambu® Aura Gain™ versus Ambu® Aura Once™ in children: a randomized, crossover study assessing oropharyngeal leak pressure and fibreoptic position

• Published in: Canadian journal of anesthesia 2019-01, Vol.66 (1), p.57-62
• Main Authors: Stögermüller, Birgit, Ofner, Sigrid, Ziegler, Bernhard, Keller, Christian, Moser, Berthold, Gasteiger, Lukas
• Format: Article
• Language: English
• Subjects: Anesthesia; Anesthesiology; Cardiology; Child; Child, Preschool; Children & youth; Comparative analysis; Critical Care Medicine; Cross-Over Studies; Female; Fiber Optic Technology; Humans; Infant; Intensive; Intubation; Intubation, Intratracheal - instrumentation; Intubation, Intratracheal - standards; Laryngeal Masks - standards; Male; Medical equipment; Medicine; Medicine & Public Health; Oropharynx; Pain Medicine; Pediatrics; Pneumology/Respiratory System; Reports of Original Investigations; Studies
• ISSN: 0832-610X; 1496-8975
• DOI: 10.1007/s12630-018-1235-7

Purpose The Ambu ® Aura Gain™ is a new second-generation supraglottic airway device that—because of a wider curvature and a wide airway tube—allows fibreoptic intubation. The purpose of this study was to assess the oropharyngeal leak pressure of the Ambu ® Aura GainTM compared with the Ambu ® Aura Once™. Methods In this randomized non-blinded crossover trial with 50 patients aged 18 months to six years (10–20 kg), we compared the Ambu ® Aura Gain™ and the Ambu ® Aura Once™ for airway maintenance in anesthetized, non-paralyzed participants. Our primary outcome was oropharyngeal leak pressure. Time of insertion, success rates for each device, evaluation of fibreoptic view and ventilation quality during anesthesia, as well as possible complications (e.g., blood staining) were assessed. Results There were no differences in first and overall insertion attempt rates (Ambu ® Aura Once™ 50/50 (100%) vs Ambu ® Aura Gain™ 50/50 (100%). Mean (standard deviation) oropharyngeal leak pressure was found to be significantly higher for Ambu ® Aura Gain™ than it was for Ambu ® Aura Once™ [21 (7) vs 19 (6) cmH 2 O, respectively; mean difference [MD] − 2 cmH 2 O; 95% confidence interval [CI], − 3.8 to − 1.0; P = 0.001]. Mean (SD) insertion time was faster for Ambu ® Aura Once™ than for Ambu ® Aura Gain™ [8 (3) vs 10 (4) seconds, respectively; MD, − 2 sec; 95% CI, − 2.9 to − 1.2; P < 0.001]. There were no differences in ventilation quality, fibreoptic view, or blood staining. Conclusion We conclude that Ambu ® Aura Gain™ is a good alternative to the Ambu ® Aura Once™ and an efficient device for children in this age group. Trial registration www.clincaltrials.gov (NCT02811042). Registered 23 June 2016.