Background Endotracheal intubation (EI) is currently required for surfactant administration. However, EI is associated with adverse physiologic effects, including bradycardia and hypoxia. The laryngeal mask airway (LMA) may provide a more practical and less invasive alternative to EI for surfactant administration.
Aim Determine feasibility of LMA placement in neonates by investigating the time, number of attempts and physiologic stability during placement of the device.
Methods Infants ≥1250 g who required surfactant administration were eligible. Videotape of the LMA placement procedure was reviewed to determine number of attempts, duration of attempts, total procedure time, and heart rate and oxygen saturation change from baseline.
Results Twenty-two infants were included in analysis. Mean total procedure time was 129 seconds (±187). Duration of attempts was 59 seconds (±81). Successful placement was achieved on the first attempt in 73% of cases. Two attempts were required in 14% of cases and all procedures were successful in ≤3 attempts. As compared to baseline, heart rate increased 3 beats per minute on average (±4, range: -3 to 11) and oxygen saturation decreased by 7% on average (±8, range: -24 to 1), as shown in Figure 1.
Conclusions Successful placement was achieved in the majority of patients in one attempt with an average total procedure time of approximately 2 min. Physiologic parameters were maintained close to baseline with minimal fluctuation in heart rate and oxygen saturation. Placement of the LMA device is feasible in neonates.