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Use of the Pro-Seal LMA facilitates percutaneous dilatational tracheostomy

L’utilisation du masque laryngé Pro-Seal facilite la trachéotomie dilatatrice percutanée

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To study the feasibility of using the Pro-Seal laryngeal mask airway (LMA) for airway maintenance during bronchoscopic guided percutaneous tracheostomy.


Observational study of 23 patients in an 11-bed general intensive care unit. The patient’s tracheal tube was exchanged for a Pro-Seal LMA before undertaking percutaneous tracheostomy.


Inspiratory pressure and tidal volumes achieved during the procedure were recorded. The median peak inspiratory pressure was 25 (standard deviation 4.2) cm H2O. There was no loss of tidal volume in 11 patients, a loss of less than 100 mL·breath-1 in 11, and loss of more than 100 mL in one. A Pro-Seal LMA successfully maintained the airway and allowed adequate ventilation during percutaneous tracheostomy in all 23 patients. In all patients bronchoscopy through the Pro-Seal LMA provided a clear view of the cords and trachea and there was no laryngeal or tracheal soiling at any stage of the procedure.


The Pro-Seal LMA provides a reliable airway and allows effective ventilation during percutaneous tracheostomy. The passage of a fibrescope through the Pro-Seal LMA and glottis is easy and provides a clear view of the upper trachea.



Étudier la faisabilité de l’utilisation du masque laryngé (ML) Pro-Seal pour maintenir la perméabilité des voies aériennes pendant la trachéotomie percutanée à guidage bronchoscopique.


L’étude par observation comportait 23 patients d’une unité de soins intensifs généraux. Un ML Pro-Seal a remplacé le tube trachéal avant la trachéotomie percutanée.


La pression inspiratoire et les volumes courants obtenus pendant l’intervention ont été notés. La moyenne de la pression inspiratoire maximale a été de 25 cm H2O (écart type de 4,2). II n’y a pas eu de perte de volume courant chez 11 patients. Une perte de moins de 100 mL·respiration-1 a été notée chez 11 patients et une perte de plus de 100 mL chez un patient. Le ML Pro-Seal a maintenu avec succès la perméabilité des voies aériennes et permis une ventilation adéquate pendant la trachéotomie percutanée chez les 23 patients. Chez tous, la bronchoscopie réalisée en passant par le ML Pro-Seal a offert une vision claire des cordes vocales et de la trachée, sans contamination laryngée ou trachéale tout au long de l’intervention.


Le ML Pro-Seal assure la perméabilité des voies aériennes et permet une ventilation efficace pendant la trachéotomie percutanée. Le passage du fibroscope par le ML Pro-Seal et la glotte est facile et permet de visualiser clairement la trachée supérieure.


  1. 1

    Ciaglia P, Firsching R, Syniec C. Elective percutaneous dilatational tracheostomy. A new simple bedside procedure; preliminary report. Chest 1985; 87: 715–9.

  2. 2

    Mercer M, Manara AR. Percutaneous tracheostomy in the intensive care unit. Curr Opin Anaesthesiol 1999; 12: 701–6.

  3. 3

    Reilly PM, Shapiro MB, Malcynski JT. Percutaneous dilatational tracheostomy under the microscope: justification for intra-procedural bronchoscopy? (Editorial). Intensive Care Med 1999; 25: 3–4.

  4. 4

    Dexter TJ. The laryngeal mask airway: a method to improve visualisation of the trachea and larynx during fibreoptic assisted percutaneous tracheostomy. Anaesth Intensive Care 1994; 22: 35–9.

  5. 5

    Zuleika M, Jacobs S, Mphanza T, Brohi F. The use of the laryngeal mask airway in suitable ICU patients undergoing percutaneous dilational tracheostomy (Letter). Intensive Care Med 1997; 23: 129–30.

  6. 6

    Dosemeci L, Yilmaz M, Gurpinar F, Ramazanoglu A. The use of the laryngeal mask airway as an alternative to the endotracheal tube during percutaneous dilatational tracheostomy. Intensive Care Med 2002; 28: 63–7.

  7. 7

    Veghese C, Rangasami J, Kapila A, Parke T. Airway control during percutaneous dilatational tracheostomy: pilot study with the intubating laryngeal mask airway. Br J Anaesth 1998; 81: 608–9.

  8. 8

    Devitt JH, Wenstone R, Noel AG, O’Donnell MP. The laryngeal mask airway and positive-pressure ventilation. Anesthesiology 1994; 80: 550–5.

  9. 9

    Brain AIJ, Verghese C, Strube PJ. The LMA ‘Pro-Seal’ — a laryngeal mask with an oesophageal vent. Br J Anaesth 2000; 84: 650–4.

  10. 10

    Cook TM, Nolan JP, Verghese C, et al. A randomized crossover comparison of the ProSeal with the classic laryngeal mask airway in unparalysed anaesthetized patients. Br J Anaesth 2002; 88: 527–33.

  11. 11

    Keller C, Brimacombe J, Kleinsasser A, Loekinger A. Does the ProSeal laryngeal mask airway prevent aspiration of regurgitated fluid? Anesth Analg 2000; 91: 1017–20.

  12. 12

    Evans NR, Llewellyn RL, Gardner SV, James MF. Aspiration prevented by the ProSeal™ laryngeal mask airway: a case report. Can J Anesth 2002; 49: 413–6.

  13. 13

    Mark DA. Protection from aspiration with the LMA-ProSeal™ after vomiting: a case report. Can J Anesth 2003; 50: 78–80.

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Correspondence to Jerry P. Nolan.

Additional information

Disclosure statement: TM Cook has received a small honorarium for a lecture delivered on behalf of Intavent.

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Craven, R.M., Laver, S.R., Cook, T.M. et al. Use of the Pro-Seal LMA facilitates percutaneous dilatational tracheostomy. Can J Anaesth 50, 718 (2003).

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  • Tidal Volume
  • Tracheal Tube
  • Laryngeal Mask Airway
  • Percutaneous Dilatational Tracheostomy
  • Percutaneous Tracheostomy