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Comparison of laryngeal mask airway and endotracheal tube placement in neonates

Journal of Perinatology volume 44, pages 239–243 (2024)Cite this article

Subjects

Abstract

Objective

We hypothesize that the time, number of attempts, and physiologic stability of placement of an LMA would be superior compared to ETT.

Study design

Videotape and physiologic parameters of LMA (n = 36) and ETT (n = 31) placement procedures for infants 28–36 weeks gestation were reviewed.

Results

Duration of attempts (32 vs 66 s, p < 0.001) and mean total airway insertion time (88 vs 153 s, p = 0.06) was shorter for LMA compared to ETT. Mean number of attempts for successful placement was fewer for LMA (1.5 vs 1.9, p = 0.11). Physiologic parameters remained near baseline in both groups despite very different degrees of premedication.

Conclusion

Placement of an LMA required less time and fewer number of attempts compared to ETT. Physiologic stability of an LMA was maintained without the use of an analgesic and muscle relaxant. Use of an LMA is a favorable alternative to ETT placement for surfactant delivery in neonates.

Trial Registration

NCT01116921.

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Data availability

Descriptive analysis of placement of the LMA has been published in Neonatology 2017; 111(3): 222-227. https://doi.org/10.1159/00045069. Deidentified individual participant data (including data dictionaries) for LMA and ETT data will be made available, in addition to study protocol, the statistical analysis plan, and the informed consent form. The data will be made available upon publication to researchers who provide a methodologically sound proposal for use in achieving the goals of the approved proposal. Proposals should be submitted to rober694@umn.edu.

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Funding

This work was supported by grants from the Minnesota Medical Foundation, Children’s Hospital Association, supporting Children’s Minnesota, and the Clinical and Translational Sciences Institute- University of Minnesota NCATS award UL1TR000114. Product support provided by LMA North America, Inc. The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Author information

Authors and Affiliations

  1. University of Minnesota Medical School, University of Minnesota, Minneapolis, MN, USA

    Amanda A. Wanous

  2. Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA, USA

    Amanda A. Wanous

  3. Division of Biostatistics, University of Minnesota, Minneapolis, MN, USA

    Roland Brown & Kyle D. Rudser

  4. Department of Pediatrics, University of Minnesota Masonic Children’s Hospital, Minneapolis, MN, USA

    Kari D. Roberts

Authors
  1. Amanda A. Wanous
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Contributions

All authors had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: Roberts. Acquisition, analysis, or interpretation of data: All authors. Drafting of the manuscript: Wanous, Roberts. Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: Brown, Rudser. Administrative, technical, or material support: Roberts. Supervision: Rudser, Roberts.

Corresponding author

Correspondence to Kari D. Roberts.

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Competing interests

K Roberts is a paid consultant for ONY Biotech. All other authors have indicated they have no potential conflicts of interest to disclose.

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Wanous, A.A., Brown, R., Rudser, K.D. et al. Comparison of laryngeal mask airway and endotracheal tube placement in neonates. J Perinatol 44, 239–243 (2024). https://doi.org/10.1038/s41372-023-01818-x

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