Laryngeal masks should be available for neonatal resuscitation.

[Stefan Johansson]

I switched hospital ~2 years ago and even if our resuscitation tables are equipped exactly the same as in the previous hospital, I have noticed that fellows here use laryngeal masks more often during resuscitation, instead of going directly from mask (+NeoPuff ventilation) to intubation.

I must say that my experience has grown very positive, laryngeal masks can be applied with little training and gives good airway support.

EBNEO has published a review here : https://ebneo.org/2015/09/airway-support-during-neonatal-resuscitation-how-effective-is-a-laryngeal-mask/
on a RCT on this specific question, laryngeal mask vs face-mask-ventilation. I fully agree with the conclusion that:

It seems reasonable that LMAs should be available for use in neonatal resuscitation and that staff caring for newborn infants should routinely be trained in their use. However, one caveat is that, despite the availability of effective and less invasive devices, we should not overlook the need to ensure adequate training in intubation for all those attending deliveries. There are, and there will undoubtedly continue to be babies for whom the optimum management will require more intensive intervention and we must work to maintain the skills needed to deliver this safely, effectively and in a timely way.

Do you have similar or other experiences to share?

Edited October 11, 2015 by Stefan Johansson

[Martin.Keszler]

I think they work, but at least here in the USA they are not available in small enough size to be useful for small preemies. Are smaller LMs available in Europe?

Thanks,

Martin Keszler MD

Professor of Pediatrics

Brown University

Edited October 12, 2015 by Martin.Keszler
added full signature

[Stefan Johansson]

@Martin.Keszler - you're right about small preterms. Our masks are designed for infants 2000 grams and up, but it has been said that a tiny mask will be around, allowing use down to 800 grams.

I work in a level2-unit right now and we care for babies from 28w and up, so a smaller device would be great. When infants <31w are delivered we have a neonatologist on site though, and if needed these babies are intubated. But for unexpected near-term/term infants, and when fellows are at the front line, they commonly use laryngeal masks if they are uncomfortable with intubation.