Airways

Published Studies and Articles Available Online Referencing the KING LT and KING LT-D™ Overall Success
	"50 patients: Insertion was determined to be easy and a patent airway was achieved in all patients." Hagberg C et at. An Evaluation of the Insertion and Function of a New Supraglottic Airway Device, the KING LT™, During Spontaneous Ventilation. Anesth Analg 2006; 102:621–5.
	175 patients: Successful mechanical ventilation in 169 patients (96.6%); unacceptable in 3 patients due to airway pressures above 40cm H2O; 3 due to unacceptable ventilation. Gaitini L et al. An Evaluation of the Laryngeal Tube During General Anesthesia Using Mechanical Ventilation. Anesth Analg 2003; 96:1750-5.
	25 patients: LT inserted successfully on the first attempt in all cases. Ocker H et al. A Comparison of the Laryngeal Tube with the Laryngeal Mask Airway During Routine Surgical Procedures. Anesth Analg 2002; 95:1094-7.
	30 patients: In all cases, the LT was inserted successfully on the first attempt. Dorges V et al. The Laryngeal Tube: A New Simple Airway Device. Anesth Analg 2000; 90:1220-2.
	60 patients: In all patients the LT was inserted successfully on the first attempt. Agro F et al. Preliminary Results Using the Laryngeal Tube for Supraglottic Ventilation. Am J Emerg Med 2002; Jan.
Difficult Airway / Emergency Airway Use
	In a large regional air medical service, the KING LT-D was used as an alternative airway after three unsuccessful ETI attempts or in situations of anticipated ETI difficulty. Most were major trauma patients with facial injuries or blood and secretions in the airway. All 26 patients managed with the KING LT-D were successfully ventilated as confirmed by continuous waveform end tidal capnography. Guyette F et al. King Airway Use by Air Medical Providers. Prehospital Emergency Care; 2007, 11:1-4. A significant time difference and simplicity exists in placing the laryngeal tube (LT), making it an attractive device for expeditious airway management. The LT’s uncomplicated design allows for successful use by a variety of healthcare providers. Russi C et al. The laryngeal tube device: a simple and timely adjunct to airway management. American Journal of Emergency Medicine; 2007, 25:263–267. Laryngeal Tube was successfully used in three patients in whom insertion of the laryngeal mask had failed. Asai T et al. Use of the laryngeal tube after failed insertion of a laryngeal mask airway. Anaesthesia 2005; 60:825-826.
	Laryngeal Tube was inserted easily and adequate ventilation was obtained after failed nasotracheal fiberoptic intubation and failed LMA insertion. Asai T. Use of the laryngeal tube for difficult fibreoptic tracheal intubation.
	The KING LT-D provides a secure, non-intubating emergency airway when direct laryngoscopy is not feasible. Fowler R. KING LT-D to the Rescue. JEMS 2005; 07:90-92.
	In an out-of-hospital emergency setting, the LT was placed in 30 patients in cardiac arrest by minimally trained nurses. Ventilation was adequate in 80% of the cases; no episodes of regurgitation or vomiting occurred and no blood staining on the LT was observed. Kette F et al. The use of laryngeal tube by nurses in out-of-hospital emergencies: Preliminary experience. Resuscitation 2005; 66:21-25.
	EMT students found that they were able to initiate ventilation more rapidly but with equal effectiveness compared to tracheal intubation; compared to BMV, they were able to provide better minute ventilation with the KING LT. Kurola et al. Airway management in cardiac arrest-comparison of the laryngeal tube, tracheal intubation and bag-valve mask ventilation in emergency medical training. Resuscitation 2004; 61:149-153.
	Case report: The LT provided adequate ventilation in two difficult airway management cases. Matioc A, Olson J. Use of the Laryngeal TubeTM in two unexpected difficult airway situations: lingual tonsillar hyperplasia and morbid obesity. Canadian Journal of Anesthesia 2004; 51:1018-1021.
	Case report: With tracheal intubation not possible, LT was inserted successfully on first attempt. Ventilation and oxygenation were possible through the LT at all times. Genzwuerker H et al. Use of the laryngeal tube for out-of-hospital resuscitation. Resuscitation 2002; 52:221-4.
	26 of 28 students stated that insertion with LT was easier than LMA. Tidal volume was significantly greater and the incidence of gastric insufflation was significantly lower with the LT. Asai T et al. Efficacy of the laryngeal tube by inexperienced personnel. Resusciation 2002; 55:171-5.
	26 of 28 students stated that insertion with LT was easier than LMA. Tidal volume was significantly greater and the incidence of gastric insufflation was significantly lower with the LT. Asai T et al. Use of the Laryngeal Tube in a patient with an unstable neck. Can J Anaesth 2002; 49(6): 642-3.
	LT has a potential role in CPR especially in elderly patients without teeth. Asai T et al. Use of the laryngeal tube in patients without teeth. Resuscitation 2001; 51:213-214.
Ventilatory Seal
	In 22 patients, the mean leak pressure was significantly greater for LT vs. LMA; gastric insufflation did not occur with the LT, but was noted in 3 patients with the LMA. Asai T et al. The laryngeal tube compared with the laryngeal mask: insertion, gas leak pressure and gastric insufflation. Br J Anaesth 2002; 89 (5):729-32.
	In a study of 50 patients, the airway leak pressure observed with the LT was 36cm H2O vs. 22cm H2O with the LMA. Ocker H et al. A Comparison of the Laryngeal Tube with the Laryngeal Mask Airway During Routine Surgical Procedures. Anesth Analg 2002; 95:1094-7.
	In 30 patients, airway pressures of 40cm H2O possible without gastric inflation. Dorges V et al. The Laryngeal Tube: A New Simple Airway Device. Anesth Analg 2000; 90:1220-2.
	Delivered tidal volume of .486L with LT compared to .500L for endotracheal tube; auscultation over the epigastrium during lung inflation with the LT showed no sign of gastric insufflation. Vollmer T et al. Fibreoptic control of the laryngeal tube position. Eur J Anaesthesiol 2002; 19:306-7.
Low Incidence of Complications
	50 patients: The unique design of the KING LT allows for ease of placement and advancement, minimizes the risk of aspiration, and has acceptable rates of both intraoperative and postoperative complications. Hagberg C et al. An Evaluation of the Insertion and Function of a New Supraglottic Airway Device, the KING LT, During Spontaneous Ventilation. Anesth Analg 2006; 102:621–5.
	In 60 patients, no adverse airway events occurred and no gastric inflation was detected. After 24 hrs no patient reported sore throat, mouth pain or dyspahagia. Agro F et al. Preliminary Results Using the Laryngeal Tube for Supraglottic Ventilation. Am J Emerg Med 2002; Jan.
	No blood was visualized in 171 of 175 cases; grade 1 upper airway trauma in 4 patients. Sore throat (12 cases) disappeared within 24 hrs (no treatment required); no complaint of hoarseness occurred. Gastric insufflation was not detected by epigastric auscultation in any patient. Gaitini L et al. An Evaluation of the Laryngeal Tube During General Anesthesia Using Mechanical Ventilation. Anesth Analg 2003; 96:1750-5.
	An in vitro study determined that the storage capacity (regurgitated volume before aspiration occurs) is 3.5ml for the LMA vs. 15ml with the LT. Miller D et al. Storage Capacities of the Laryngeal Mask and Laryngeal Tube Compared and Their Relevance to Aspiration Risk During Positive Pressure Ventilation. Anesth Analg 2003; 96:1821-2.
Likelihood of LT Tip Entering Trachea
	In 500 attempts in a mannequin, no inadvertent tracheal intubation occurred. Even using a laryngoscope, the LT could not be placed in the trachea due to the form and length of the tube. Genzwuerker H et al. The Laryngeal Tube: A New Adjunct for Airway Management. Prehosp Emerg Care 2000; 4(2):168-72.
Tracheal Intubation After Placement of the KING LT
	Fiberoptic placement of a tube exchange catheter through the LT allowed successful switch to tracheal intubation in 9 of 10 patients. Genzwueker H et al. Fibreoptic tracheal intubation after placement of the laryngeal tube. Br J Anaesth 2002; 89(5):733-8.
	After placement of the LT in a 24 yr old male with multiple fractures of the jaw, fiberoptic nasotracheal intubation along side the LT was accomplished. Asai T et al. Use of the laryngeal tube for nasotracheal intubation. Br J Anaesth 2001; 87(1).