Facial growth dynamics dictate optimal facemask fitting during the first year of life.

Aim: The aim of this study is to prevent mask leak during ventilation in infant emergencies, appropriate facemask fitting is essential. Therefore, we investigated facial profiles during the first year of life and their correlation with the correct sizing of masks.

Methods: This is a post hoc subgroup analysis of 32 healthy term infants, based on a prospective observational study performed from September 2018 to December 2019 in Tuebingen, Germany.

Comparison of nostril sizes of newborn infants with outer diameter of endotracheal tubes.

Background: Recommendations for endotracheal tube (ETT) size usually refer to the inner diameter (ID). Outer diameters (OD), however, vary greatly between manufacturers, which in some brands might cause difficulties in passing the ETT through the nostrils if choosing the nasal route for intubation. Even though the nostrils are dilatable by an ETT, it might be difficult to pass an ETT through the posterior naris (narrowest point of the nasal passage), if the OD is bigger than the nostrils.

An approach to define newborns´ sniffing position using an angle based on reproducible facial landmarks.

Background: The neutral or sniffing position is advised for mask ventilation in neonates to avoid airway obstruction. As definitions are manifold and often unspecific, we wanted to investigate the reliability and reproducibility of angle measurements based on facial landmarks that may be used in future clinical trials to determine a hypothetical head position with minimal airway obstruction during mask ventilation.

Methods: In a prospective single-center observational study, 2D sagittal photographs of 24 near-term and term infants were taken, with five raters marking facial landmarks to assess interobserver agreement of those landmarks and angle δ, defined as the angle between the line parallel to the lying surface and the line crossing Subnasale (Sn) and Porion' (P').

Do commonly available round facemasks fit near-term and term infants?

Objective: With inappropriately large facemasks, it is more difficult to create a seal on the face, potentially leading to ineffective ventilation during neonatal stabilisation. We investigated whether commonly available round facemasks are of appropriate size by measuring facial dimensions in near-term and term infants using two-dimensional (2D) and three-dimensional (3D) images.

Design: Prospective single-centre observational study.