Supreme Laryngeal Mask Airway versus Face Mask during Neonatal Resuscitation: A Randomized Controlled Trial

Trevisanuto, Daniele; Cavallin, Francesco; Nguyen, Loi Ngoc; Nguyen, Tien V.; Tran, Linh Dieu; Tran, Chien Dinh; Doglioni, Nicoletta; Micaglio, Massimo; Moccia, Luciano

doi:10.1016/j.jpeds.2015.04.051

Cited by 66 publications

(76 citation statements)

References 26 publications

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“…Data on laryngeal mask use in preterm infants less than 34 weeks’ gestation are limited; however, several reports describe their successful use in infants weighing less than 1,500 g 16,17. A recent study of the effectiveness of laryngeal mask by Trevisanuto et al found that in newborns with a gestational age of 34 weeks and/or expected birth weight of 1,500 g needing positive-pressure ventilation at birth, the laryngeal mask was more effective than the face mask to prevent endotracheal intubation 18. Additionally, the laryngeal mask was effectively implemented in clinical practice after only a short educational intervention 18.…”

Section: Advances In Practicementioning

confidence: 99%

Neonatal resuscitation: advances in training and practice

Sawyer¹,

Umoren²,

Gray³

2016

AMEP

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Each year in the US, some four hundred thousand newborns need help breathing when they are born. Due to the frequent need for resuscitation at birth, it is vital to have evidence-based care guidelines and to provide effective neonatal resuscitation training. Every five years, the International Liaison Committee on Resuscitation (ILCOR) reviews the science of neonatal resuscitation. In the US, the American Heart Association (AHA) develops treatment guidelines based on the ILCOR science review, and the Neonatal Resuscitation Program (NRP) translates the AHA guidelines into an educational curriculum. In this report, we review recent advances in neonatal resuscitation training and practice. We begin with a review of the new 7th edition NRP training curriculum. Then, we examine key changes to the 2015 AHA neonatal resuscitation guidelines. The four components of the NRP curriculum reviewed here include eSim®, Performance Skills Stations, Integrated Skills Station, and Simulation and Debriefing. The key changes to the AHA neonatal resuscitation guidelines reviewed include initial steps of newborn care, positive-pressure ventilation, endotracheal intubation and use of laryngeal mask, chest compressions, medications, resuscitation of preterm newborns, and ethics and end-of-life care. We hope this report provides a succinct review of recent advances in neonatal resuscitation.

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Section: Advances In Practicementioning

confidence: 99%

Neonatal resuscitation: advances in training and practice

Sawyer¹,

Umoren²,

Gray³

2016

AMEP

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“…The demographic data demonstrates that the LMAS was used primarily in older children, with the average age being 12 years old. As a device capable of use in even the neonatal population with a high success rate, we would have hoped for a younger median age (10)(11)(12). This might simply reflect a lack of experience with the LMAS in younger patients by anesthesia providers or some general unwillingness to utilize supraglottic airways in younger patients.…”

Section: Discussionmentioning

confidence: 99%

Laryngeal Mask Airway Supreme in Children: A Retrospective Audit

Tran¹,

Olomu²,

Bocanegra³

et al. 2016

J Anesth Perioper Med

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Background:The laryngeal mask airway (LMA) Supreme (LMAS) is a sophisticated, second-generation supraglottic airway device, with an improved seal, and gastric access. It is a capable device for use in more complex procedures and in younger children. No study has been able to analyze a large pediatric sample of patients to assess how the LMAS is being utilized. In this retrospective audit, we evaluated the use of the LMAS in routine clinical practice. In addition to this, utilization of LMAS performance test was evaluated. Methods: A retrospective audit was performed of a major tertiary children's hospital's electronic medical record database to identify all children in whom the LMAS was utilized for airway management over a two-year period. In addition to demographic data, we collected the following LMAS data: size of the LMAS, the number of insertion attempts, volume of air injected into the cuff, the cuff pressure, and the oropharyngeal leak pressure. We also recorded the performance of tests for proper position and function, the mode of lung ventilation, the use of muscle relaxants and use of any alternative airway devices. Results: The LMAS was used in 418 children accounting for only 4% of all LMA usage and only 0.6% of all usage for general anesthesia. The first-attempt placement success rate was 96.4% (382/396). Five of 418 (1.2% ) insertions were reported as failures. Mechanical ventilation was used in only 26% of cases with a vast majority (74% ) breathing spontaneously. Cuff pressure was measured in 74/418 (18% ) of cases. Oropharyngeal leak pressures were measured in 90/418 (21.5% ) cases. Maneuvers performed to verify correct placement and performance of the LMAS were rarely performed. Use of the LMAS for invasive procedures occurred in only 5 cases (1.2%). Conclusions: This study shows the LMAS to be highly successful in the hands of various cadres of anesthesia providers at a major tertiary hospital and performs reliably well. Our data reveals many areas of potential improvement for use of the LMAS in the pediatric population, as a device capable for usage in more invasive surgical procedures, younger patients, and mechanical ventilation.

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“…No information is provided regarding the blinding process. In the last of these 3 trials, Trevisanuto et al [30] compared LMA and FM ventilation in 142 infants (born at >34 weeks' GA and with a BW >1,500 g) assigned randomly to one of the devices. In this trial, for the first time, the LMA Supreme was used instead of the LMA Classic.…”

Section: Lma (N = 24) Vs Ett (N = 25)mentioning

confidence: 99%

The Laryngeal Mask Airway and Its Use in Neonatal Resuscitation: A Critical Review of Where We Are in 2017/2018

Bansal

Caoci

Dempsey³

et al. 2017

Neonatology

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fants, but the evidence is still insufficient to recommend the LMA instead of FM ventilation in the DR. There is, in particular, a dearth of evidence of the use of LMA in neonates born before 34 weeks' gestational age or weighing <1,500 g at birth. There were no reports on significant complications following the use of LMA; however, evidence is still limited regarding short-and long-term outcomes. We conclude that the limited currently available evidence suggests that the use of the LMA is a feasible and safe alternative to mask ventilation of late preterm and term infants in the DR. The potential use of LMA resuscitation, in particular for low-gestation and low-birth-weight infants, needs further study.

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Supreme Laryngeal Mask Airway versus Face Mask during Neonatal Resuscitation: A Randomized Controlled Trial

Cited by 66 publications

References 26 publications

Neonatal resuscitation: advances in training and practice

Neonatal resuscitation: advances in training and practice

Laryngeal Mask Airway Supreme in Children: A Retrospective Audit

The Laryngeal Mask Airway and Its Use in Neonatal Resuscitation: A Critical Review of Where We Are in 2017/2018

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