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© 2022 Via Medica. All rights reserved.Background: Recent advances in airway management have led to supraglottic airway devices (SAD) being increasingly often chosen instead of tracheal intubation for laparoscopic surgery. However, there are ongoing arguments regarding the use of SAD due to worries about the risks of insufficient ventilation and pulmonary aspiration. The LMA Protector is a second generation SAD which was put into use recently. This prospective randomised trial investigated whether the LMA Protector was comparable to the tracheal tube regarding respiratory parameters, perioperative complications and haemodynamic parameters in patients undergoing laparoscopic surgery. Methods: A total of 154 adult patients were randomised to two groups: Group 1 (tracheal intubation) and Group 2 (LMA Protector). Achieving adequate depth of anaesthesia, the patients were either intubated or the LMA Protector was placed. The initial baseline measurements were recorded including tidal volume, peak inspiratory pressure (PIP), oropharyngeal leak pressure (OLP) and haemodynamic parameters. These measurements were repeated and recorded again following pneumoperitoneum and recovery from anaesthesia. Results: At the mean age of 52.22 ± 13.90 years 77 patients were intubated and in 77 patients the LMA Protector was applied. Following insertion of the airway device and pneumoperitoneum, the heart rate was higher in the intubation group. In the LMA Protector group OLP measures were found to be statistically similar. The mean Brimacombe fibreoptic visualisation score was 2.12 ± 0.58 and the rate of requirement of optimisation was 15% in the LMA Protector group. Conclusions: With high OLP, better haemodynamic parameters and low laryngeal view scores, we concluded that the LMA Protector can be used safely in patients undergoing laparoscopic surgery.

© 2022 Via Medica. All rights reserved.Penetrating thoracic trauma accounts for 20-25% of all deaths due to trauma in the first four decades of life. About 33% of deaths from thoracic trauma occur due to penetrating trauma. In an autopsy study that enrolled 1178 trauma patients, 82% of the patients with tracheobronchial injuries died at the incidence site. In another study, 30% of those who could be transferred to the hospital died. This review aimed to revisit penetrating thoracic trauma with respect to complications and the strategies for airway management. While the risk of death in injuries with a sharp object is normally 1-8%, it reaches 25-28% when the cardiac box is included, and still, most of the patients are lost before they can come to the hospital. The consequences and management of penetrating thoracic trauma are mainly dependent on the extent of the injury to internal organs, as well as on the skill of the clinicians, airway obstruction, respiratory failure, and bleeding. Chest computed tomography (CT) is better than chest radiography in diagnosing the main bronchus or lobe/segment rupture. However, with the use of multi-channel multi-detector CT, the sensitivity of CT imaging has increased to 94% in the diagnosis of tracheobronchial injuries. While standard orotracheal intubation is sufficient in 75% of the patients, flexible bronchoscopy, intubation through the open wound or tracheostomy is required for airway provision in the rest. Clinical suspicion is the first diagnostic tool in a patient with penetrating airway trauma, and early treatment with multidisciplinary teamwork is life-saving.