Are we creating a blockage of blood flow to the brain?
This article has created quite a stir in the resuscitation community:
Impairment of carotid artery blood flow by supraglottic airway use in a swine model of cardiac arrest. Segal N, Yannopoulos D, Mahoney BD, Frascone RJ, Matsuura T, Cowles CG, McKnite SH, Chase DG. Resuscitation. 2012 Mar 28.
Are EGAs harming carotid blood flow during CPR and therefore making neurological outcomes worse? At least in pigs, this is worrisome. Human data to follow.
What am I going to do with this? At least for now, keep using LMAs (the device associated with the least problems), but now I will check cuff pressure to make sure it stays below 40 cm H20
Andy Neill has an amazing Anatomy for Emergency Medicine Post on this very issue