Clinical paperDelivery room resuscitation of near-term infants: Role of the laryngeal mask airway☆
Section snippets
Patients and methods
We searched the electronic medical records of all infants delivered at the Padua University Hospital (Padua, Italy) between January 2002 and December 2006 (inclusive) to identify those delivered near-term, 34 0/7–36 6/7 weeks’ gestation, based on best obstetric estimates. The Padua University Hospital is a tertiary teaching hospital with approximately 4000 births and 350 admissions to the Neonatal Intensive Care Unit (NICU) each year. The records of all near-term infants who required PPV for
Results
During the 5-year study period, 18,641 live births were recorded including 921 infants (4.9%) delivered between 34 0/7 and 36 6/7 weeks’ gestational age. The annual proportion of near-term infants ranged from 3.1% to 5.9% (Table 1). Eighty-six of the near-term infants (9.3%, range: 4.4–24.1%) were resuscitated with PPV in the delivery room and form the study group for this review (Table 1).
Resuscitators chose to provide PPV with the BFM and LMA devices most frequently. LMA was used in 36
Discussion
Premature birth is known to place infants at increased risk for both mortality and morbidity compared with infants who are born at term.14 A subgroup of ‘near-term’ or ‘late premature’ infants (34–36 6/7 weeks’ gestation) have recently become the focus of increased interest since they manifest signs of physiologic immaturity and delayed transition despite relatively large size and apparent functional maturity.14, 19 In the neonatal period, these infants have an increased risk for medical
Conclusions
In a single unit with appropriate training and guidelines, the LMA can be used at a clinician's discretion to deliver PPV effectively to infants delivered between 34 and 37 weeks’ gestation. This may be due to the experience and confidence that our physicians have developed with this device and the individualised approach implemented in our delivery room. Prospective randomised trials are needed to confirm the potential advantages of the LMA in neonatal resuscitation of near-term infants.26
Conflict of interest
No conflict of interest.
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Cited by (40)
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2022, ResuscitationCitation Excerpt :The full text of this CoSTR can be found on the ILCOR website.226 The SysRev identified 5 RCTs227–231 and 1 quasi-RCT232 involving a total of 1857 newborn infants and 2 retrospective cohort studies233,234 involving 218 newborn infants. An additional study235 reported secondary outcomes from a subset of newborn infants enrolled in an included RCT.228
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2018, A Practice of Anesthesia for Infants and ChildrenSupreme Laryngeal Mask Airway versus Face Mask during Neonatal Resuscitation: A Randomized Controlled Trial
2015, Journal of PediatricsCitation Excerpt :All these studies enrolled patients with gestational age ≥34 weeks and birth weight >2000 g.14 These inclusion criteria were in agreement with International Liaison Committee on Resuscitation recommendations.1,2 Based on previous observational studies,10-12 we included smaller patients (birth weight >1500 g) because this population is more frequently in need of resuscitation in delivery room. Our results suggest that the SLMA can be effectively and safely used also in patients with a birth weight <2000 g.
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A Spanish translated version of the abstract of this article appears as Appendix in the final online version at doi:10.1016/j.resuscitation.2009.11.005.