Articles and Studies

A positive paper for the feline v-gel® Advanced with the ease of placement for students being duly noted. The v-gel® Advanced provided effective ventilation and oxygenation in the cats with no issues in 46 of the 51 cats in the study. The authors acknowledge that not all complications were device related.
The author has acknowledged that some of the cats had a C2 placed, as they were borderline of the weight guide, whereby retrospectively they feel a C3 would have been a better choice. So, of the approximate 13% of cases that showed a leak in all ventilation categories, these could have been the same cats with potentially the wrong size place. Subsequently they could also be the same ones that gastric material was seen in the airway channel (3 cases), author noted not all cats would have been fasted.
The size guide provided by Docsinnovent is based on ideal body weight and there is often an overlap of sizes with some patients on these borderlines. As with any airway device, the largest device that is possible to place safely is always the better choice.
Docsinnovent also advise checking of the seal before any continual ventilation is applied by either the manual raising of the chest to hold and check for leaks or using an in-line manometer. (see more information in our FAQs)

Docsinnovent’s official published response to above paper.

Morgane Debuigne et al.

This study confirms the v-gel® Advanced was easy to place with all cats achieved a good airway seal with no leaks whilst undergoing controlled mechanical ventilation and no complications during the trial. The author acknowledged the improvements in this device gave less issues occasionally seen with the original v-gel®. In the authors criteria of positioning, those cases that fell outside of perfect in respect of oesophageal seal, did not have any bloating and were never associated with any safety concerns for the patient. Any oesophageal gas seen was minimal and the author noted some trapping of gas after initial placement of the device before assisted ventilation was initiated, this can occur with endotracheal intubation too.

Sadly, the author has misunderstood relationship with supraglottic airway devices (SGADs) and laryngeal mask airways (LMAs), with many of her references being on LMAs. You can read more on our FAQs page (general questions).

Zoltán Szilágyi et al.

This study, although appears negative, does confirm that a seal was achieved when using the v-gel® Advanced but not necessarily sufficient for assisted ventilation. The dog v-gel® is only recommended for spontaneous breathing patients and ideal in cases which are at higher risk of reflux and regurg. The separate gastric channel allows the operator to acknowledge and treat the presence of gastric material, whilst isolating the airway channel from potential aspiration.

The challenge for the dog v-gel® is the infinite range of head shapes and sizes across the breeds and cross-breeds. At present there is a limited number of dog v-gel ® sizes, so although these give a good seal for spontaneous breathing in the given size ranges (as noted in this published paper), the clinician would have check on a case-by-case basis if the seal pressure was adequate for both manual or mechanical assisted breathing. Docsinnovent always recommend a gentle IPPV breath to test the seal gained before continuing with additional, longer term assisted breathing.