A supraglottic airway is an airway that does not pass across the vocal cords, such as an oropharyngeal airway or a laryngeal mask. Intubation of the trachea with a cuffed tube is the only way to simultaneously provide a secure airway, repeated access to the trachea and ventilatory support. Unfortunately, the placement of an artificial airway, be it a supraglottic airway or an endotracheal or tracheostomy tube, bypasses many of the patient's natural defences and thus increases the risk of upper and lower airway colonization, aspiration and infection. For anything other than immediate life support, however, the airway needs to be secured with a cuffed endotracheal tube, or in some circumstances, a tracheostomy endotracheal intubation in the critically ill patient carries challenges over and above those encountered during routine anaesthesia airway management because of a number of additional complicating factors. A primary goal of airway management is oxygenation.