• Joe Holley, Robert Dunne, Heather Robinson, Richard Williams, and Andisheh Motealleh.
• Department of Emergency Medicine, University of Tennessee, Memphis, Tennessee; Medical Director, Memphis Fire Department and State of Tennessee, Memphis, Tennessee.
• J Emerg Med. 2025 Feb 1; 69: 253125-31.

BackgroundSupraglottic airway (SGA) devices are frequently used during cardiopulmonary respiration (CPR), but little is known about their ability to consistently seal the airway during CPR.ObjectivesThe objective of this prospective crossover human cadaver study was a comparison of intrathoracic pressures (ITPs) generated during automated CPR (aCPR) with an Impedance Threshold Device (ZOLL Medical Corporation, Chelmsford, MA) with six currently available SGAs to a standard endotracheal tube (ETT). The hypothesis was that current SGAs would vary in their ability to develop ITPs compared with the ETT.MethodsAirway pressures and negative ITP were measured in six recently deceased human cadavers of varying body habitus. After placement of an ETT and six different SGAs, we assessed airway and ITPs during aCPR and manual positive pressure ventilation using bag-valve mask. The ETT served as the control for airway seal and was placed first followed by each SGA. Primary outcome compared airway and ITP among all groups.ResultsSGAs varied in their ability to create negative airway pressure and negative ITP.ConclusionIn this human cadaver model, the ability to generate negative ITP varied with different SGAs during aCPR with an Impedance Threshold Device.Copyright © 2024 Elsevier Inc. All rights reserved.

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