Use of laryngeal mask airway in transferred infants: a retrospective study

Abstract

Abstract Background Laryngeal mask airway (LMA) may be considered by health care givers of level I-II hospitals for neonatal resuscitation in interhospital care, but literature provides little information on this aspect. This study reviewed the use of LMA in a large series of neonates who underwent postnatal transfer by an Italian regional transport service.Methods This is a retrospective study evaluating the use of LMA in infants who underwent emergency transport by the Eastern Veneto Neonatal Emergency Transport Service between January 2003 and December 2021. All data were obtained from transport registry, transport forms and hospital charts.Results 64/3,252 transferred neonates (2%) received ventilation with a LMA, with increasing trend over time (p = 0.001). Most neonates were transferred after birth (97%) due to a respiratory or neurologic disease (95%). LMA was used before the transport (n = 60), during the transport (n = 1) or both (n = 3). No device-related adverse effects were recorded. Sixty-one neonates (95%) survived and were discharged/transferred from the referral center.Conclusions In a large series of transferred neonates, LMA use was rare but increasing over time, and showed some heterogeneity among referring centers. However, LMA was safe and lifesaving in “cannot intubate, cannot oxygenate” situations. Future prospective, multicenter research may provide detailed insights on LMA use in neonates needing postnatal transport.