A prospective evaluation of the efficacy of the laryngeal mask airway during neonatal resuscitation

Objective

To study the feasibility, efficacy and safety of using the laryngeal mask airway (LMA) in neonatal resuscitation.

Methods

In total, 369 neonates (gestational age ≥34 weeks, expected birth weight ≥2.0 kg) requiring positive pressure ventilation at birth were quasi-randomised to resuscitation by LMA (205 neonates) or bag-mask ventilation (164 neonates).

Results

(1) Successful resuscitation rate was higher with the LMA compared with bag-mask ventilation (P < 0.001) and the total ventilation time was shorter with the LMA than with bag-mask ventilation (P < 0.001). Seven of nine neonates with an Apgar score of 2 or 3 at 1 min after birth were successfully resuscitated in the LMA group, while in the BMV group all six neonates with an Apgar score of 2 or 3 at 1 min required tracheal intubation and ventilation. In neonates with an Apgar score of 4 or 5 at 1 min after birth, successful resuscitation rate with the LMA was higher than with bag-mask ventilation (P < 0.01). (2) Successful insertion rate of the LMA at the first attempt was 98.5% and the insertion time was 7.8 s ± 2.2 s. There were few adverse events (vomiting and aspiration) in the LMA group.

Conclusion

The LMA is safe, effective and easy to implement for the resuscitation of neonates with a gestational age of 34 or, more weeks.