The laryngeal mask is a valuable tool to use in neonatal resuscitation, a study shows

background

Nearly one million newborns will die in 2020 because they don’t start breathing at birth. Additionally, breathing problems at birth will result in much greater brain damage. Immediately getting air into the lungs of any newborn who is not breathing can help prevent brain damage.

In most countries, midwives, not doctors, care for infants who are not breathing after delivery and ventilate infants. The standard of care is to use a self-inflating balloon or bag and a face mask. This is a difficult skill. There is a high risk of air leaks, which means less oxygen will reach the brain.

The laryngeal face mask is a short tube that acts as an airway. It is placed directly in the throat. It fits snugly minimizing the risk of air leaks and thus ensuring that air reaches the lungs. Larynx masks are currently used by anesthesiologists during surgical procedures, but were previously not available for use by midwives resuscitating newborns.

She studies

The maternity service at Mulago National Referral Hospital in Kampala, Uganda, provided a unique opportunity to conduct a large randomized trial. There are around 25,000 births in Mulago every year, far more than in any Norwegian hospital and, indeed, in most European and North American ones.

About 200 midwives were trained in the new technique. After just one day of training, the midwives said they felt comfortable with the new technique and found it easier to use than the standard face mask and bag. Over 1000 children were resuscitated during the 2018-2019 study period. The children were randomly assigned to one or the other resuscitation technique.

Results

The results showed that the laryngeal mask is a valuable new tool for use in neonatal resuscitation. The technique can be easily taught and safely used by midwives. While infant survival was not improved with the laryngeal mask compared to the standard of care, face mask and bag, more infants who were first resuscitated with face masks were therefore saved with laryngeal masks than the reverse.