Trevisanuto Daniele, Gizzi Camilla, Cavallin Francesco, Beke Artur, Buonocore Giuseppe, Charitou Antonia, Cucerea Manuela, Filipović-Grčić Boris, Jekova Nelly Georgieva, Koç Esin, Saldanha Joana, Stoniene Dalia, Varendi Heili, De Bernardo Giuseppe, Madar John, Hogeveen Marije, Orfeo Luigi, Mosca Fabio, Vertecchi Giulia, Moretti Corrado
Department of Women's and Children's Health, University Hospital of Padua, Padua, Italy.
Department of Neonatology and NICU, Ospedale Sant'Eugenio, Rome, Italy.
Neonatology. 2024;121(6):780-790. doi: 10.1159/000538808. Epub 2024 Jun 4.
Laryngeal mask airway (LMA) use in neonatal resuscitation is limited despite existing evidence and recommendations. This survey investigated the knowledge and experience of healthcare providers on the use of the LMA and explored barriers and solutions for implementation.
This online, cross-sectional survey on LMA in neonatal resuscitation involved healthcare professionals of the Union of European Neonatal and Perinatal Societies (UENPS).
A total of 858 healthcare professionals from 42 countries participated in the survey. Only 6% took part in an LMA-specific course. Some delivery rooms were not equipped with LMA (26.1%). LMA was mainly considered after the failure of a face mask (FM) or endotracheal tube (ET), while the first choice was limited to neonates with upper airway malformations. LMA and FM were considered easier to position but less effective than ET, while LMA was considered less invasive than ET but more invasive than FM. Participants felt less competent and experienced with LMA than FM and ET. The lack of confidence in LMA was perceived as the main barrier to its implementation in neonatal resuscitation. More training, supervision, and device availability in delivery wards were suggested as possible actions to overcome those barriers.
Our survey confirms previous findings on limited knowledge, experience, and confidence with LMA, which is usually considered an option after the failure of FM/ET. Our findings highlight the need for increasing the availability of LMA in delivery wards. Moreover, increasing LMA training and having an LMA expert supervisor during clinical practice may improve the implementation of LMA use in neonatal clinical practice.
尽管已有相关证据和建议，但喉罩气道（LMA）在新生儿复苏中的应用仍然有限。本次调查旨在探究医疗服务提供者对LMA使用的知识和经验，并探讨实施过程中的障碍及解决方案。
本次关于新生儿复苏中LMA的在线横断面调查涉及欧洲新生儿和围产医学学会联盟（UENPS）的医疗专业人员。
共有来自42个国家的858名医疗专业人员参与了此次调查。只有6%的人参加过LMA专项课程。部分产房未配备LMA（26.1%）。LMA主要在面罩（FM）或气管插管（ET）失败后才会被考虑使用，而首选仅限于患有上呼吸道畸形的新生儿。LMA和FM被认为更容易放置，但比ET效果差，同时LMA被认为比ET侵入性小，但比FM侵入性大。与FM和ET相比，参与者感觉对LMA的操作能力和经验较少。对LMA缺乏信心被视为其在新生儿复苏中实施的主要障碍。建议在产房增加培训、监督和设备供应，作为克服这些障碍的可能措施。
我们的调查证实了之前关于LMA知识、经验和信心有限的研究结果，LMA通常被视为FM/ET失败后的一种选择。我们的研究结果强调了在产房增加LMA供应的必要性。此外，增加LMA培训并在临床实践中配备LMA专家监督员可能会改善LMA在新生儿临床实践中的应用。
