Delivery room resuscitation of near-term infants: Role of the laryngeal mask airway

作者：Zanardo Vincenzo^*; Weiner Gary; Micaglio Massimo; Doglioni Nicoletta; Buzzacchero Ramona; Trevisanuto Daniele

来源：Resuscitation, 2010, 81(3): 327-330.

DOI：10.1016/j.resuscitation.2009.11.005

• Bag-face mask
• Laryngeal mask airway
• Endotracheal tube
• Near-term infant
• Neonatal resuscitation

Aim: This observational Study aims to describe: (1) the use of positive pressure ventilation (PPV) for resuscitation in the delivery room among newly born near-term infants; (2) the methods used for PPV resuscitation [e.g., bag-facial mask (BFM), laryngeal mask airway (LMA), endotracheal tube (ETT)]: and (3) the association of each device with short-term neonatal outcomes.
Methods: We identified near-term (34 0/7-36 6/7 weeks) infants delivered at the Padua University Hospital (Padua, Italy) during the years 2002-2006. The mode of delivery, gestational age, birth weight, Apgar scores, methods of resuscitation and respiratory Outcome after NICU admission were analysed.
Results: During the 5-year Study period, 921 (4.9%) near-term infants were identified from a total of 18,641 live births. PPV was provided in the delivery room to 86 (9.3%) of these infants. Among them, 36 (41.8%) were managed by LMA, 34 (39.5%) by BFM and 16 (18.6%) by ETT. Thirty-four (39.5%) resuscitated near-term infants were admitted to the Neonatal Intensive Care Unit (NICU): 15 (44.1%) after BFM, 12 (75%) after ETT and seven (19.4%) after LMA. Resuscitation with an ETT was associated with all increased rate of respiratory distress syndrome when compared with either BFM or LMA. Resuscitation with all LMA was associated with a lower rate of NICU admission and shorter length of stay when compared with either BFM or ETT.
Conclusion: The LMA is all effective device for primary airway management of near-term infants and for secondary airway management among near-term infants failing BFM or ETT resuscitation.

• 出版日期2010-3