would use. But since there isn't one yet, and each has its disadvantages
and advantages, manufacturers are constantly trying to work around
the difficulties."
Since the creation of the classic laryngeal mask airway (LMA) more
than 2 decades ago, manufacturers have tinkered with the design of
these minimally invasive airways and created variations ideal for dif-
ferent patient populations and specialties. Here are 7 SGA features to
consider.
1. High-pressure vs. low-pressure seal
"Traditionally, we'd give every patient who needed high-pressure ven-
tilation an endotracheal (ET) tube, since a classic LMA doesn't pro-
vide a tight enough seal in the airway," says Dr. Frederick. "Since
then, they've made ones that are for higher pressure, though it's still
not as high as an endotracheal tube would allow."
You can use a low-pressure seal for patients who are breathing on
their own and don't need help from the machine, says Dr. Frederick,
while high-pressure seals are ideal for overweight patients who require
more forceful ventilation. For example, Dr. Frederick notes that if you
treat a lot of overweight patients, look into a model with a double seal
mechanism, or one made of a gel-like material that molds to the
patient's airway as it warms up. "When you insert it, it can form a tight
seal around the airway," she says. "It works really well in heavier
patients with an abnormal anatomy, which is becoming more com-
mon."
2. Gastric access
One of the biggest concerns with SGAs is the risk of aspiration.
Manufacturers have addressed that concern in the latest devices by
offering a gastric channel that lets you insert a nasogastric tube to
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