Respiratory monitoring during neonatal resuscitation using a supraglottic airway device vs. a face mask

Nicolas J Pejovic; Francesco Cavallin; Allan Mpamize; Clare Lubulwa; Susanna Myrnerts Höök; Josaphat Byamugisha; Jolly Nankunda; Thorkild Tylleskär; Daniele Trevisanuto

doi:10.1016/j.resuscitation.2021.10.025

Respiratory monitoring during neonatal resuscitation using a supraglottic airway device vs. a face mask

Resuscitation. 2022 Feb:171:107-113. doi: 10.1016/j.resuscitation.2021.10.025. Epub 2021 Oct 22.

Authors

Nicolas J Pejovic¹, Francesco Cavallin², Allan Mpamize³, Clare Lubulwa³, Susanna Myrnerts Höök⁴, Josaphat Byamugisha⁵, Jolly Nankunda⁶, Thorkild Tylleskär⁷, Daniele Trevisanuto⁸

Affiliations

¹ Centre for International Health, University of Bergen, Bergen, Norway; Neonatal Unit, Sachs' Children and Youth Hospital, Stockholm, Sweden; Karolinska Institute, Department of Public Health Sciences, Stockholm, Sweden. Electronic address: njpejovic@live.se.
² Independent Statistician, Solagna, Italy.
³ Mulago National Referral Hospital, Kampala, Uganda.
⁴ Centre for International Health, University of Bergen, Bergen, Norway; Neonatal Unit, Sachs' Children and Youth Hospital, Stockholm, Sweden; Karolinska Institute, Department of Public Health Sciences, Stockholm, Sweden.
⁵ Mulago National Referral Hospital, Kampala, Uganda; Dept. of Obstetrics and Gynecology, College of Health Sciences, Makerere University, Uganda.
⁶ Mulago National Referral Hospital, Kampala, Uganda; Dept. of Pediatrics and Child Health, College of Health Sciences, Makerere University, Uganda.
⁷ Centre for International Health, University of Bergen, Bergen, Norway; Centre for Intervention Studies in Maternal and Child Health, University of Bergen, Bergen, Norway.
⁸ Dept. of Woman's and Child's Health, University of Padova, Padova, Italy.

PMID: 34695444
DOI: 10.1016/j.resuscitation.2021.10.025

Abstract

Objective: To evaluate the respiratory function of asphyxiated infants resuscitated with i-gel supraglottic airway (SGA) vs. face mask (FM) in a low-resource setting.

Methods: In this sub-study from the NeoSupra trial, respiratory function during the first 60 inflations was evaluated in 46 neonates (23 with SGA and 23 with FM) at the Mulago National Referral Hospital, Uganda. The primary outcome was the mask leak (%). The secondary outcomes included inspired (VTi) and expired (VTe) tidal volumes, and heart rate response to ventilation.

Results: Median mask leak was 40% (IQR 22-52) with SGA and 39% (IQR 26-62) with FM (p = 0.38). Median VTe was 7.8 ml/kg (IQR 5.6-10.2) with SGA and 7.3 ml/kg (IQR 4.8-11.9) with FM (p = 0.84), while median VTi was 15.4 ml/kg (IQR 11-4-17.6) with SGA and 15.9 ml/kg (IQR 9.0-22.6) with FM (p = 0.68). A shorter time was needed to achieve heart rate > 100 bpm in SGA (median 13 s IQR 9-15) with respect to FM arm (median 61, IQR 33-140) (p = 0.0002).

Conclusion: Respiratory function was not statistically different between neonates resuscitated with SGA vs. FM. SGA was associated with faster heart rate recovery compared to FM in the subgroup of neonates with bradycardia. Further research is needed to investigate possible advantages of SGA on respiratory function at birth.

Keywords: Birth asphyxia; Global health; Intrapartum-related complications; Laryngeal mask; Newborn infant; Resuscitation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Humans
Infant, Newborn
Laryngeal Masks*
Masks*
Monitoring, Physiologic
Resuscitation / methods
Tidal Volume
Uganda