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Objective:The laryngeal mask airway(LMA) is an established way for airway control during spontaneous ventilation.Its ability to deliver positive pressure ventilation without leakage especially in low flow states is still controversy.The aim of this study is to test the possibility of using LMA in pediatric closed circuit controlled ventilation,and to find out the optimum cuff volume to perform closed system ventilation.Methods:Twenty children scheduled for elective surgeries were enrolled in a crossover study.Laryngeal mask airway was used.In stage I,the cuff was inflated with the maximum volume of air as recommended by the manufacturers.Adjustment of volume of air inflated into the LMA cuff to the minimum volume to obtain the effective seal was done at stage II.The leak pressure,intracuff pressure and the leak volume were measured in both stages.Results:The cuff filling volume was significantly lower compared to the maximum cuff inflation volume in stage I.Leakage values showed significantly less values in stage II of the study with smaller cuff inflation volumes.The airway leakage pressure was significantly lower in stage II in comparison to stage I.Cuff inflation pressure in stage I showed marked elevation which dropped significantly after adjustment of cuff volume in stage II.Conclusion:Laryngeal mask airway is an effective tool to provide closed circuit controlled ventilation in pediatrics.Inflation of the cuff by the minimum volume of air needed to reach the just sealing pressure is suggested to minimize the leakage volume.
Objective: The laryngeal mask airway (LMA) is an established way for airway control during spontaneous ventilation. Iz ability to deliver positive pressure ventilation without leakage especially in low flow states is still controversy. The aim of this study is to test the possibility of using LMA in pediatric closed circuit controlled ventilation, and to find out the optimum cuff volume to perform closed system ventilation. Methods: Twenty children scheduled for elective surgeries were enrolled in a crossover study. Laryngeal mask airway was used. Stage I, the cuff was inflated with the maximum volume of air as recommended by the manufacturers. Adjustment of volume of air inflated into the LMA cuff to the minimum volume to obtain the effective seal was done at stage II. leak pressure, intracuff pressure and the leak volume were measured in both stages. Results: The cuff filling volume was significantly lower compared to the maximum cuff inflation volume in stage I. Leakage values showed signif icantly less values in stage II of the study with smaller cuff inflation volume. The airway leakage pressure was significantly lower in stage II in comparison to stage I. Population inflation pressure in stage I showed marked elevation which dropped significantly after adjustment of cuff volume in stage II. Conlusion: Laryngeal mask airway is an effective tool to provide closed circuit controlled ventilation in pediatrics. Inflation of the cuff by the minimum volume of air needed to reach the just sealing pressure is suggested to minimize the leakage volume.