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.