NEONATAL RESUSCITATION

THE USE OF LARYNGEAL MASK AIRWAY

Abstract

Background: The key to success in newborn resuscitation is the
knowledge about the neonatal physiology and adequate preparation of the staff involved in the resuscitation process.
The pulmonary part of the resuscitation can be accomplished with either Endotracheal Tube (ETT) or Face Mask (FM),
both of these techniques require expertise and are associated with high rates of failure. Hence a third potential option
has been suggested to overcome these problems. Objectives: To evaluate the efficacy of Laryngeal Mask Airway
(LMA) in neonatal resuscitation and artificial ventilation and to compare it with that of ETT and FM. To evaluate LMA’s
efficiency in situation where endotracheal intubation and facemask ventilation is difficult or not possible. Design: A Non
interventional, analytical / comparative study Setting: Combined Military Hospital Rawalpindi. Period: 20 weeks (1st
January 2002 to 31 May 2002). Subjects: A group of 75 neonates born with C-Section were selected on the basis of
non-probability convenience sampling. They were subdivided into three sub gps with 25 neonates in each sub gp.
Interventions; 75 neonates born after C-Section, were divided into sub gps i.e. A, B, and C containing a no of 25
neonates in each gp. They were ventilated with ETT, FM and LMA respectively. These newborn babies had an Apgar
score < 4. They were resuscitated using a fix protocol. The efficacy of ventilation with either technique was evaluated
in terms of placement and ventilation. Results: The LMA emerged, as a valuable and better option in newborn
resuscitation. Moreover, it was a successful tool in situations where endotracheal intubation and facemask ventilation
was difficult or impossible. Conclusion: The LMA is a potential valuable adjunct for the management of neonatal
airway.