Neonatal Resuscitation Using the Laryngeal Mask Airway

Paterson, Scott J.; Byrne, Paul; Molesky, M; Seal, Robert F.; Finucane, Brendan T.

doi:10.1097/00000542-199406000-00012

Cited by 165 publications

(64 citation statements)

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“…55,56 Appropriately sized LMAs should be available for all intubations, particularly when any difficulty is anticipated. LMAs have been used successfully in late-preterm and term newborns weighing more than 2500 g.…”

Section: Discussionmentioning

confidence: 99%

Premedication for Nonemergency Endotracheal Intubation in the Neonate

Kumar¹,

Denson²,

Mancuso³

et al. 2010

Pediatrics

190

211

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Section: Discussionmentioning

confidence: 99%

Premedication for Nonemergency Endotracheal Intubation in the Neonate

Kumar¹,

Denson²,

Mancuso³

et al. 2010

Pediatrics

190

211

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“…Successful use in neonates for the purpose of resuscitation has been published. 117 Lighted stylets are now available for use with endotracheal tubes as small as size #2. Hs-2~ The tracheas of 83.2% of 125 children were intubated with an LS in the largest paediatric series published.…”

Section: Role Of Newer Technology In the Management Of The Difficult mentioning

confidence: 99%

The unanticipated difficult airway with recommendations for management

et al. 1998

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The unanticipated difficult airway with recommendations for managementPurpose: To review the current literature and generate recommendations on the role of newer technology in the management of the unanticipated difficult airway. Methods: A literature search using key words and filters of English language and English abstracted publications from contained in the Medline, Current Contents and Biological Abstracts databases was carried out. The literature was reviewed and condensed and a series of evidence-based recommendations were evolved. Conclusions: The unanticipated difficult airway occurs with a low but consistent incidence in anaesthesia practice. Difficult direct laryngoscopy occurs in 1,5 -8.5% of general anaesthetics and difficult intubation occurs with a similar incidence. Failed inubation occurs in 0.13-0.3% general anaesthetics. Current techniques for predicting difficulty with laryngoscopy and intubation are sensitive, non-specific and have a low positive predictive value. Assessment techniques which utilize multiple characteristics to derive a risk factor tend to be more accurate predictors. Devices such as the laryngeal mask, lighted styler and rigid fibreoptic laryngoscopes, in the setting of unanticipated difficult airway, are effective in establishing a patent airway, may reduce morbidity and are occasionally lifesaving. Evidence supports their use in this setting as either alternatives to facemask and bag ventilation, when it is inadequate to support oxygenation, or to the direct laryngoscope, when tracheal intubation has failed, Specifically, the laryngeal mask and Combitube TM have proved to be effective in establishing and maintaining a patent airway in "cannot ventilate" situations. The lighted stylet and Bullard (rigid) fibreoptic scope are effective in many instances where the direct laryngoscope has failed to facilitate tracheal intubation. The data also support integration of these devices into strategies to manage difficult airway as the new standard of care. Training programmes should ensure graduate physicians are trained in the use of these alternatives. Continuing medical education courses should allow physicians in practice the opportunity to train with these alternative devices.Objectif : Passer en revue la documentation courante et fournir des recommandations sur le r61e de la nou velle technologie dans la conduite ~ tenir Iors d'une intubation difficile. M~thodes : On a procEdE ~ une recherche documentaire selon des mots-clEs et des filtres de langue anglaise et des publications de rEsumEs anglais de 1990 ~ 1996, contenus dans les bases de donnEes de Medline, Current Contents et Biolo~colAbstracts.La littErature a ErE revue et r&umEe et une sErie de recommandations basEes sur les fairs ont ErE ElaborEes. Conclusion : Les dit~cultEs d'intubation non prEvues surviennent selon une incidence faible, mais constante, clans la pratique de I'anesthEsie, Des probl~mes de laryngoscopie directe et des difficult& d'intubation ont lieu dans 1,5 -8,5 % des anesth&ies gEnErales. E&hec de I'...

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“…51 There is limited data on the use of these devices in small preterm infants, 52 however, and their use in the setting of meconium-stained amniotic fluid has not been studied. The laryngeal mask airway, when used by appropriately trained providers, may be an effective alternative for establishing an airway in resuscitation of the newly born infant, especially in the case of ineffective bag-mask ventilation or failed endotracheal intubation (Class Indeterminate, LOE 5).…”

Section: Laryngeal Mask Airway Ventilationmentioning

confidence: 99%

International Guidelines for Neonatal Resuscitation: An Excerpt From the Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: International Consensus on Science

2000

Pediatrics

414

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The International Guidelines 2000 Conference on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiac Care (ECC) formulated new evidenced-based recommendations for neonatal resuscitation. These guidelines comprehensively update the last recommendations, published in 1992 after the Fifth National Conference on CPR and ECC. As a result of the evidence evaluation process, significant changes occurred in the recommended management routines for: • Meconium-stained amniotic fluid: If the newly born infant has absent or depressed respirations, heart rate <100 beats per minute (bpm), or poor muscle tone, direct tracheal suctioning should be performed to remove meconium from the airway. • Preventing heat loss: Hyperthermia should be avoided. • Oxygenation and ventilation: 100% oxygen is recommended for assisted ventilation; however, if supplemental oxygen is unavailable, positive-pressure ventilation should be initiated with room air. The laryngeal mask airway may serve as an effective alternative for establishing an airway if bag-mask ventilation is ineffective or attempts at intubation have failed. Exhaled CO2 detection can be useful in the secondary confirmation of endotracheal intubation. • Chest compressions: Compressions should be administered if the heart rate is absent or remains <60 bpm despite adequate assisted ventilation for 30 seconds. The 2-thumb, encircling-hands method of chest compression is preferred, with a depth of compression one third the anterior-posterior diameter of the chest and sufficient to generate a palpable pulse. • Medications, volume expansion, and vascular access: Epinephrine in a dose of 0.01–0.03 mg/kg (0.1–0.3 mL/kg of 1:10,000 solution) should be administered if the heart rate remains <60 bpm after a minimum of 30 seconds of adequate ventilation and chest compressions. Emergency volume expansion may be accomplished with an isotonic crystalloid solution or O-negative red blood cells; albumin-containing solutions are no longer the fluid of choice for initial volume expansion. Intraosseous access can serve as an alternative route for medications/volume expansion if umbilical or other direct venous access is not readily available. • Noninitiation and discontinuation of resuscitation: There are circumstances (relating to gestational age, birth weight, known underlying condition, lack of response to interventions) in which noninitiation or discontinuation of resuscitation in the delivery room may be appropriate.

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Neonatal Resuscitation Using the Laryngeal Mask Airway

Cited by 165 publications

References 0 publications

Premedication for Nonemergency Endotracheal Intubation in the Neonate

Premedication for Nonemergency Endotracheal Intubation in the Neonate

The unanticipated difficult airway with recommendations for management

International Guidelines for Neonatal Resuscitation: An Excerpt From the Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: International Consensus on Science

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