Clearing the airway? A pilot cadaveric study of the LifeVac™ device

Background

Foreign body aspiration (FBA) is a leading cause of accidental death, especially among children and older adults. Suction-based airway clearance devices, such as the LifeVac™, an FDA-registered Class II medical device, have garnered attention as potential adjunctive tools in FBA management; however, data on their efficacy remain limited. This study evaluated the performance of the LifeVac™ in a cadaveric model simulating complete upper airway obstruction by commonly aspirated food items.

Methods

Fresh cadavers with intact upper airway anatomy were used. Grapes, hot dog slices, and steak cubes were placed at the level of the true vocal folds under video-laryngoscopic guidance. Interventions were performed by a PGY-1 otolaryngology resident and a board-certified head and neck surgeon, following LifeVac™ manufacturer instructions. The primary outcome was successful foreign body removal within four minutes. Secondary outcomes included time to removal and evidence of oropharyngeal trauma. All trials were video recorded for technique verification and injury assessment.

Results

Across 21 trials performed on three cadavers, only one successful extraction occurred (1/21, 4.8 %), involving a hot dog segment removed by a PGY-1 resident. One cadaver was edentulous, which resulted in a poor mask seal and ineffective suction. No grapes or steak were successfully extracted. No visible oropharyngeal trauma was identified.

Conclusion

In this cadaveric model, LifeVac™ demonstrated limited efficacy, with successful removal occurring in only one instance. It is unclear if the lack of efficacy is due to device design or the limitations of the cadaveric model. Further research in physiologic or clinical settings is warranted.