Use of the layngeal mask airway in neonatal resuscitation

Laryngeal Mask Airway for neonatal resuscitation in a developing country: evaluation of an educational intervention. Neonatal LMA: an educational intervention in DRC

“…Some case reports have, moreover, shown the successful use of the LMA in resuscitation of newborns with congenital airway abnormality under inadequate ventilation and difficult intubation settings [26,27]. Tests on neonatal intubation training models have shown that midwives and interns can obtain a clear airway more rapidly with LMA than TT and with fewer failures with LMA than with TT [28]. …”

Alternative Ventilation Strategies: Laryngeal Masks

“…Subjects were more successful inserting the laryngeal mask than the ETT with a lower first-attempt failure rate and shorter insertion time. The only two studies focusing on teaching neonatal laryngeal mask placement reported high success rates with brief didactic training and practice, but success was measured using only a neonatal resuscitation manikin [22,23]. Both of these studies are limited by the failure to show that successful insertion in a mechanical model is predictive of success with a live patient during a resuscitation.…”

“…Observational studies describing laryngeal masks used with neonates to administer anesthesia, to facilitate endotracheal intubation, or to facilitate diagnostic bronchoscopy were assigned to level of evidence 7 (extrapolation) regardless of methodology. In total, our search identified 48 relevant studies, including one Cochrane systematic review [15], one small randomized controlled trial [16], two nonrandomized cohort studies [2,17], three large uncontrolled case series [18][19][20], three mechanical or animal models [21][22][23], and multiple smaller case series or individual case reports for neonatal resuscitation [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] and other nonresuscitation purposes [11,[42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57]…”

The laryngeal mask airway: potential applications in neonates

“…5-7 30 Whereas successful intubation may require more than one attempt, the LMA is easily inserted by non-anaesthetist personnel. 40 LMA insertion does not require the use of neuromuscular blocking agents, further diminishing pharmacological risk in neonates.…”

“…They also show that the incidence of failure is lower with the LMA. 40 The use of the LMA for neonatal resuscitation has been reported in three case series. 15 42 43 Altogether 220 neonates were included in these three observational studies (table 1).…”