Laryngeal mask airway: is the management of neonates requiring positive pressure ventilation at birth changing?
OBJECTIVE
To evaluate the impact of the laryngeal mask airway (LMA) on neonatal resuscitation policy.


METHODS
We analyzed retrospectively the records of neonates requiring positive pressure ventilation (PPV) at birth before (1996) and after (2000) the introduction of the LMA into our delivery suites. In addition, the outcome of neonates treated with the LMA was compared with that of neonates matched for gestational age and mode of delivery who were resuscitated using a face mask.


RESULTS
During the year 2000, 95 out of 380 (25%) resuscitated neonates were treated with the LMA. The LMA was effective in 94 out of 95 (99%) of these infants. Over the same period, the percentage of neonates receiving tracheal intubation (TI) at birth (34%) was significantly reduced compared with the figure for 1996 (67%). There were no reported complications associated with the use of the LMA. Seventy-four out of the 95 neonates treated with the LMA were considered suitable for matching for gestational age and mode of delivery with 74 neonates treated with a face mask. No differences were found between the two groups for birth weight, Apgar scores, need for tracheal intubation, need for admission to the Neonatal Intensive Care Unit (NICU), primary diagnosis at discharge and primary outcomes. The LMA provided effective ventilation in four neonates in whom the face mask failed.


CONCLUSIONS
The LMA is changing neonatal resuscitation practice in our Institution. Our data suggest that it is a safe and useful alternative method for respiratory support in neonates requiring PPV at birth, which merits further study.
Pediatric Department, University of Padova, Via Giustiniani, Neonatal Intensive Care Unit, Azienda Ospedaliera Padova, 3, 35158 Padova, Italy. trevo@pediatria.unipd.it
Daniele
D
Trevisanuto
Massimo
M
Micaglio
Mariangela
M
Pitton
Mariella
M
Magarotto
Daniele
D
Piva
Vincenzo
V
Zanardo
D001724:Birth Weight; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007442:Intubation, Intratracheal; D017214:Laryngeal Masks; D008297:Male; D008397:Masks; D011175:Positive-Pressure Respiration; D012151:Resuscitation / Q000379:methods*; D012189:Retrospective Studies