Neonatal Resuscitation with the Laryngeal Mask Airway in Normal and Low Birth Weight Infants

Gandini, Donna; Brimacombe, J.

doi:10.1097/00000539-199909000-00018

Cited by 43 publications

(42 citation statements)

References 4 publications

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“…A further study, conducted in a middle‐income country, confirmed that the neonatal LMA Supreme (Teleflex Inc, Wayne, PA, USA) was more effective than a face mask in preventing endotracheal intubation in newborns with a gestational age of 34 weeks or more and, or, an expected birthweight of at least 1500 g needing PPV at birth 15. All these studies were conducted using a cuffed supraglottic airways device 6, 7, 8, 9, 10. The innovative design of the I‐gel could simplify insertion and should be well suited for this task.…”

Section: Discussionmentioning

confidence: 94%

“…In the setting of neonatal resuscitation, previous observational studies have showed that LMA allowed effective PPV in most of the patients that were treated, with a range of 95–99% 6, 7, 8. One quasi‐randomised study showed that the LMA was more effective than face mask ventilation for neonates with an Apgar score of 2–5 at one minute after birth.…”

Section: Discussionmentioning

confidence: 99%

“…The laryngeal mask airway (LMA) may be considered during resuscitation as an alternative to FMV or ETT for PPV in newborns weighing more than 2000 g or delivered around, or after, 34 weeks of gestation 5. Several publications including a Cochrane review have shown that LMA achieved effective PPV in most of the treated patients, with a range of 95–99% 6, 7, 8, 9 and reduced the need for ETT 1, 10. In all of the previous studies, a classic inflatable size 1 LMA was used.…”

Section: Introductionmentioning

confidence: 99%

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Pilot manikin study showed that a supraglottic airway device improved simulated neonatal ventilation in a low‐resource setting

et al. 2016

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AimWe compared the performance of personnel in a low‐resource setting when they used the I‐gel cuffless neonatal laryngeal mask or a face mask on a neonatal airway management manikin.MethodsAt Mulago Hospital, Uganda, 25 doctors, nurses and midwives involved in neonatal resuscitation were given brief training with the I‐gel and face mask. Then, every participant was observed positioning both devices on three consecutive occasions. The success rate and insertion times leading to effective positive pressure ventilation (PPV) were recorded. Participants rated the perceived efficiency of the devices using a five‐point Likert scale.ResultsThe I‐gel achieved a 100% success rate on all three occasions, but the face mask was significantly less effective in achieving effective PPV and the failure rates at the first, second and third attempts were 28%, 8% and 20%, respectively. The perceived efficiency of the devices was significantly superior for the I‐gel (4.7 ± 0.4) than the face mask (3.3 ± 0.8).ConclusionThe I‐gel was more effective than the face mask in establishing PPV in the manikin, and user satisfaction was higher. These encouraging manikin data could be a stepping stone for clinical research on the use of the I‐gel for neonatal resuscitation in low‐resource settings.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pilot manikin study showed that a supraglottic airway device improved simulated neonatal ventilation in a low‐resource setting

et al. 2016

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“…Die Attraktivität der Larynx maske liegt u. a. darin, dass die notwen digen manuellen Fähigkeiten einfacher und rascher zu lernen und beizubehalten sind als die technisch anspruchsvollere Laryngoskopie und die endotracheale In tubation [47]. Larynxmasken der Grö ße 1 sind für Neugeborene und Säuglinge mit einem Gewicht von 2,5-5 kg zugelas sen. Es gibt aber auch Berichte von ihrem Einsatz bei Frühgeborenen mit einem Ge burtsgewicht von weniger als 1500 g [15]. Im Rahmen einer Neugeborenenreanima tion ist es denkbar, dass mit einer Larynx maske aufgrund des maximalen Okklusi onsdrucks von 2-2,5 kPa (20-25 cmH 2 O) nur ein unzureichend hoher intrapulmo naler Druck erzeugt werden kann, um die Lunge ein erstes Mal zu belüften (s. Ab schn.…”

Section: Larynxmaskeunclassified

Reanimation des Neugeborenen

Berger

Pilgrim

2008

Anaesthesist

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Although almost 10% of all newborn infants need some form of respiratory assistance after birth, only 1% will require more advanced forms of resuscitation. Because these rare events cannot always be anticipated, pediatricians and neonatologists may not be readily available and resuscitation will have to be performed by anesthesiologists. In recent years, international guidelines for neonatal resuscitation have been revised by the International Liaison Committee on Resuscitation (ILCOR), the American Academy of Pediatrics (AAP) and the American Heart Association (AHA), as well as the European Resuscitation Council (ERC). The revised guidelines describe a simplified resuscitation algorithm which emphasizes the central role of respiratory support and an increase in heart rate is judged to be the best marker for successful ventilation. In deliveries complicated by meconium-stained amniotic fluid, intrapartum suctioning of the oropharynx is no longer recommended and endotracheal suctioning is restricted to severely depressed babies. The new guidelines mention the use of the laryngeal mask airway (LMA) and CO(2) detectors without, however, making firm recommendations. The use of 100% oxygen in neonatal resuscitation is increasingly being challenged. In the rare event of a newborn whose heart rate drops below 60 beats/min, more advanced resuscitation (chest compressions using the 2-thumb-encircling-hands technique, epinephrine 10-30 mug/kgBW i.v.) will be required. Finally, the guidelines mention the possible neuroprotective effect of therapeutic hypothermia after asphyxia, but finally only recommend that hyperthermia should be avoided.

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“…Eine 7 endexspiratorische CO 2 -Messung gibt zusätzliche Sicherheit bezüglich der 7 korrekten Tubuslage und ausreichender Ventilation.Ist eine Beatmung über Rachentubus oder Maske nicht möglich, gelingt meist eine Ventilation über eine Larynxmaske (z. B. Größe 1 bis zu 5 kg KG; die Verwendung der Größe 1 bis zum Gewicht von 1,2 kg bei Frühgeborenen wurde berichtet[4,18]). Diese stellt ein entscheidendes Hilfsmittel bei den genannten Kieferfehlbildungen dar; allerdings muss ihr Einsatz vorher geübt werden.…”

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Besondere Notfallsituationen bei Früh- und Reifgeborenen

Hoehn

Humpl

Zimmermann

et al. 2008

Monatsschr Kinderheilkd

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Auf der Grundlage der Empfehlungen des International Liaison Committee on Resuscitation ( ILCOR) und neuer Studien ist u. E. zu empfehlen, die Reanimation eines Neugeborenen im Kreiß-saal unabhängig vom Gestationsalter -bis auf wenige Ausnahmen -mit Raumluft zu beginnen und nur bei klinischem Bedarf die inspiratorische Sauerstoffkonzentration zu erhöhen. Ferner plädie-ren die Autoren vorerst für eine Beibehaltung des intrapartalen Absaugens bei mekoniumhaltigem Fruchtwasser und die Anwendung therapeutischer Hypothermie bei reifen und nahezu reifen, asphyktischen Neugeborenen. Insbesondere Mekoniumaspiration, primäres Atemnotsyndrom des Frühgeborenen und ductusabhängige Herzfehler erfordern ein differenziertes, problemorientiertes Vorgehen in OP und Kreißsaal, im Rettungsdienst und auf der Intensivstation. Im Folgenden wird auf den schwierigen Atemweg, das Management der Mekoniumaspiration, die Versorgung Neugeborener mit kritischen angeborenen Herzfehlern und die Erstversorgung von Frühgebore-nen <1500 g Geburtsgewicht im Detail eingegangen. AbstractOn the basis of the recommendations of the International Liaison Committee on Resuscitation (ILCOR 2005) and recent clinical trials, we recommend initiating the resuscitation of term and preterm infants with room air (certain exceptions apply) and adjusting the inspiratory oxygen concentration depending on the newborn's clinical condition ("tailored oxygen resuscitation"). We continue to recommend, until further clinical data become available, intrapartum airway suctioning in cases of meconium-stained amniotic fluid, as well as the use of therapeutic hypothermia in asphyxic term and near-term newborn infants. Meconium aspiration, duct-dependent congenital heart disease, and respiratory distress syndrome require a particular problem-oriented approach in the operating and delivery room, during transport, and in the intensive care unit. The difficult airway, the management of meconium aspiration, critical congenital heart disease, and preterm newborn infants weighing less than 1500 g are discussed in detail.

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Neonatal Resuscitation with the Laryngeal Mask Airway in Normal and Low Birth Weight Infants

Cited by 43 publications

References 4 publications

Pilot manikin study showed that a supraglottic airway device improved simulated neonatal ventilation in a low‐resource setting

Pilot manikin study showed that a supraglottic airway device improved simulated neonatal ventilation in a low‐resource setting

Reanimation des Neugeborenen

Besondere Notfallsituationen bei Früh- und Reifgeborenen

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