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Do commonly available round facemasks fit near-term and term infants?
  1. Bianca Haase1,
  2. Ana Maria Badinska1,
  3. Bernd Koos2,
  4. Christian F Poets1,
  5. Laila Lorenz1
  1. 1 Department of Neonatology, Universitätsklinikum Tübingen, Tübingen, Germany
  2. 2 Department of Orthodontics, Universitätsklinikum Tübingen, Tübingen, Germany
  1. Correspondence to Dr Bianca Haase, Department of Neonatology, Universitätsklinikum Tübingen, Tübingen 72076, Germany; bianca.haase{at}


Objective With inappropriately large facemasks, it is more difficult to create a seal on the face, potentially leading to ineffective ventilation during neonatal stabilisation. We investigated whether commonly available round facemasks are of appropriate size by measuring facial dimensions in near-term and term infants using two-dimensional (2D) and three-dimensional (3D) images.

Design Prospective single-centre observational study.

Setting Infants born in our centre at 34–41 weeks’ gestation were eligible.

Intervention Patients were photographed with 2D and 3D technique.

Main outcome measures Distances between nasion and gnathion were measured and compared with the outer diameter of various round facemasks.

Methods 2D and 3D images were performed using standard equipment. Correlations between gestational age and the above-mentioned distances were assessed using Pearson’s r.

Results Images were taken from 102 infants with a mean (SD) gestational age of 37.9 (2.3) weeks. Mean distance between nasion and gnathion was 46.9 mm (5.1) in 2D and 49.9 mm (4.1) in 3D images, that is, on average 3 mm smaller in 2D than with 3D (p<0.01). Based on these measurements, round facemasks with an external diameter of 50 mm seemed fitting for most (61%) term infants and 42 mm masks for most (72%) near-term infants (GA 34–36 weeks).

Conclusions Round facemasks with an external diameter of 60 mm are too large for almost all newborn infants, while 42/50 mm round facemasks are well fitting. Important anatomical structures were only visible using 3D images.

Clinical trial registration number NCT03369028

  • delivery room
  • mask ventilation
  • mask leak
  • facemask
  • newborn
  • 3D
  • 2D

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  • Contributors BH has written the manuscript. BH and AMB were involved in the study design, patient recruitment, data collection and analysis. LL had the idea. AMB and LL have reviewed the manuscript. AMB, LL and CFP was involved in the study design and has contributed to each draft of the manuscript. BK sponsored the 3DMD Camera System, did the project supervision and has seen and contributed to each draft of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests AMB was supported by an intramural grant from Tuebingen University Hospital.

  • Patient consent for publication Parental/guardian consent obtained.

  • Ethics approval The institutional ethics committee approved the study and written informed parental consent was obtained (approval number: 704/2017BO1).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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