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5.2.2. Test 2 - Inflation/deflation test
Make sure that the manual vent is closed prior to carrying out this test. Ambu recommends
deflating the cuff of the Ambu® Aura40 completely. Once deflated, check the cuff thoroughly for
any wrinkles or folds. Over-inflate the cuff to the appropriate volume as specified in Table 7. Check
that the inflated cuff is symmetrical and smooth. There should not be any bulge nor any sign of
leakage in the cuff, pilot tubing or pilot balloon.
Mask Size
#1
#1½
#2
#2½
#3
#4
#5
#6
Over-inflation
Cuff volumes
6 ml
10 ml
15 ml
21 ml
30 ml
45 ml
60 ml
75 ml
Table 7. Test cuff over-inflation volumes for the Ambu® Aura40
6. Specialized use
6.1. Intubation through the Ambu® Aura40
It is recommended to use an exchange catheter for intubation through the Ambu® Aura40.
A flexible fiberscope can be used through the Ambu® Aura40 to view the airway. It is important to
pre-oxygenate the patient and to use standard monitoring procedures. Fiberoptic intubation via
the AmbuAura40 can be done using an exchange catheter.
The Ambu® Aura40 is inserted and an exchange catheter is treaded over the fiberscope. The
fiberscope is inserted until carina is seen and the exchange catheter is “railroaded” and left in
the trachea. The Ambu® Aura40 is removed. The ET-tube is put onto the exchange catheter and
“railroaded” down into the trachea. The exchange catheter is removed.
6.2. Use of the Ambu® Aura40 for blind tracheal intubation
There is currently no published data on blind tracheal intubation through the Ambu® Aura40.
We have therefore no clinical evidence to verify success rate and useful technique. We can
therefore not recommend blind tracheal intubation through Ambu® Aura40.
6.3. Paediatric use
The Ambu® Aura40 comes in four different sizes for paediatric patients. See table 1 for selection
guidelines and maximum inflation volumes.
It is recommended that the Ambu® Aura40 in neonates and small children is used by an
anaesthesiologist familiar with paediatric patients and already experienced in adult laryngeal mask
airway management.
The insertion of the Ambu® Aura40 in paediatric patients can be performed in the same way as
described for adults following either intravenous or gaseous induction. It is important that an
adequate level of anaesthesia (or unconsciousness) is achieved before insertion.
The insertion should be successful at the same level of anaesthesia that would be suitable for
tracheal intubation.
Please note that with the Ambu® Aura40, as with any form of airway management and anaesthesia
in paediatric patients, where ventilation is insufficient, desaturation is likely to occur faster because
of the higher oxygen consumption of paediatric patients.
