The intubating laryngeal mask airway compared with direct laryngoscopy

We have compared the ability of naive intubators to intubate the trachea us ing a laryngoscope and an intubating laryngeal mask airway (ILMA) after rec eiving basic training, in a randomized, prospective, crossover study in 60 patients. Ventilation of the lungs via the ILMA was also compared with vent ilation with a face mask. There was no significant difference in successful intubation between the techniques (38 of 89 with the ILMA and 33 of 93 wit h direct laryngoscopy; ns). In patients in whom participants failed in thei r intubation attempts with the ILMA, investigators achieved success in 89% (16 of 18). Satisfactory ventilation was more common with the ILMA (50 of 5 1) than with the face mask (43 of 60) (P = 0.0001). A total of 98% (89 of 9 1) of ILMA were inserted successfully, with a mean insertion time of 19.6 s , and 78% (69/89) of these insertions were achieved in less than 26 s. The ILMA may be useful for emergency oxygenation and ventilation, but these res ults do not support its use for intubation by those not trained in advanced airway management and ILMA use.