Safe and effective management of the neonatal airway requires knowledge, teamwork, preparation and experience. At baseline, the neonatal airway can present significant challenges to experienced neonatologists and paediatric anaesthesiologists, and increased difficulty can be due to anatomical abnormalities, physiological instability or increased situational stress. Neonatal airway obstruction is under recognised, and should be considered an emergency until the diagnosis and physiological implications are understood. When multiple types of difficulties are present or there are multiple levels of anatomical obstruction, the challenge increases exponentially. In these situations, preparation, multi-disciplinary teamwork and a consistent hospital-wide approach will help to reduce errors and morbidity.
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http://dx.doi.org/10.1016/j.siny.2023.101483 | DOI Listing |
J Trop Pediatr
December 2024
Division of Neonatology, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, 06800, Turkey.
This study aimed to identify risk factors for noninvasive ventilation (NIV) failure in <30 weeks' gestation preterm neonates and compare morbidity in patients with and without NIV failure. This study included preterm neonates <30 weeks' gestation who received NIV support for respiratory distress syndrome (RDS). Demographic and clinical characteristics were compared between infants with and without NIV failure within the first 72 hours after birth.
View Article and Find Full Text PDFPediatr Res
January 2025
Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, AB, Canada.
Background: Positive pressure ventilation (PPV) in the delivery room is routinely performed using a face mask attached to a ventilation device. In 2023, the Consensus of Science and Treatment Recommendations for neonatal resuscitation stated that a supraglottic airway (SGA) can be used for PPV if resources and training permits. However, there is very limited data on tidal volume (V) delivery using SGAs.
View Article and Find Full Text PDFArch Dis Child Fetal Neonatal Ed
January 2025
Department of Neonatology, The National Maternity Hospital, Dublin, Ireland.
Background: The Neonatal Resuscitation Program recommends direct laryngoscopy (DL) as the primary method for neonatal intubation. Video laryngoscopy (VL) is suggested as an option, particularly for training novice operators or for intubating infants with difficult airways. The programme outlines specific steps for intubation, including managing the external environment and techniques for visualising key anatomical landmarks.
View Article and Find Full Text PDFEur J Pediatr
January 2025
Hospital de Clinicas de Porto Alegre, Rua Silva Jardim 1155 # 701, Porto Alegre, RS, 90450-071, Brazil.
Unlabelled: To evaluate the accuracy of the lung ultrasound score (LUS) in predicting ventilatory weaning failure during neonatal hospitalization in the NICU and to identify factors associated with weaning failure, including corrected gestational age (CGA). This prospective, longitudinal, pragmatic and observational cohort study included neonates on mechanical ventilation for at least 48 h. The primary outcome was the accuracy of lung ultrasound in predicting 3-day weaning failure, with the ROC curve used to determine the best LUS cutoff (sensitivity and specificity).
View Article and Find Full Text PDFAAPS PharmSciTech
January 2025
Department of Mechanical and Nuclear Engineering, Virginia Commonwealth University, Richmond, VA, United States of America.
The administration of surfactant aerosol therapy to preterm infants receiving continuous positive airway pressure (CPAP) respiratory support is highly challenging due to small flow passages, relatively high ventilation flow rates, rapid breathing and small inhalation volumes. To overcome these challenges, the objective of this study was to implement a validated computational fluid dynamics (CFD) model and develop an overlay nasal prong interface design for use with CPAP respiratory support that enables high efficiency powder aerosol delivery to the lungs of preterm infants when needed (i.e.
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