Subject(s)
Airway Obstruction/etiology , Laryngeal Masks/adverse effects , Drainage , Equipment Failure , Esophagus/physiology , Humans , PostureABSTRACT
BACKGROUND: The laryngeal mask airway (LMA(TM), Laryngeal Mask Co. Ltd, Jersey, UK) is a supraglottic device used to administer positive pressure ventilation (PPV) in adults, pediatric and neonatal patients. OBJECTIVES: To avoid endotracheal intubation, we evaluated the feasibility and practicality of administering surfactant via the LMA(TM) in preterm infants with respiratory distress syndrome (RDS). METHODS: Infants less than 72 h old with a gestational age of < or =35 weeks and a birth weight of >800 g, treated with nasal continuous positive airway pressure (CPAP, 5 cm H2O) for RDS were eligible for inclusion in the study if the arterial-to-alveolar oxygen tension ratio (a/APO2) was <0.20 over a period of >60 min. RESULTS: Eight preterm infants, median gestational age 31 (range 28-35) weeks; birth weight 1,700 (880-2,520) g, treated with nasal CPAP for RDS were enrolled. Three hours after surfactant instillation, the mean a/APO2 was significantly increased (0.13 +/- 0.04 to 0.34 +/- 0.11; p < 0.01) without complications. CONCLUSIONS: The LMA may be a useful and noninvasive conduit for the administration of surfactant therapy. A large randomized comparative clinical trial will be required to confirm the efficacy of this technique.
Subject(s)
Biological Products/administration & dosage , Infant, Premature/physiology , Laryngeal Masks , Phospholipids/administration & dosage , Pulmonary Surfactants/administration & dosage , Respiratory Distress Syndrome, Newborn/drug therapy , Blood Gas Analysis , Continuous Positive Airway Pressure , Female , Humans , Infant, Newborn , Infant, Premature/blood , Male , Respiratory Distress Syndrome, Newborn/bloodABSTRACT
Airway control during interhospital transport may present enormous management difficulties, even for experienced personnel. The laryngeal mask airway is an airway management device that has been established as a safe reliable tool in adult and pediatric practice. We describe 2 cases of successful interhospital transfer of infants with congenital airway malformations with the use of the laryngeal mask airway, and we review the literature.
