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

Background: Foreign body aspiration (FBA 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.