Abstract:
OBJECTIVE: In 2015, Neonatal Resuscitation Program (NRP) recommended laryngeal mask airway (LMA) as an alternative to the endotracheal tube (ETT) in situations where the provider is "unable to intubate and unable to ventilate." LMA insertion is being taught in the NRP routinely. However, endotracheal intubation is the primary method considered as the standard of care in neonatal resuscitation. LMA insertion is a relatively simple procedure with an average insertion time of < 10 seconds. Newer generation LMA can have the added advantage of reducing the risk of aerosol generation and improving the safety of the providers. Only a few recent studies have evaluated the LMA insertion skills of neonatal resuscitation providers. We wanted to study the proficiency of NRP providers in the technique of LMA insertion. We hypothesized that NRP providers would have LMA insertion skills equivalent to the standard of care (ETT insertion). STUDY: DESIGN: A manikin-based study was done from July 2019 to December 2019. We enrolled 31 NRP providers with 1 or more years since the first certification and current valid NRP provider/instructor status. The participants were instructed to insert an ETT and LMA in the manikin. The procedures were video recorded. The time taken to insert and start ventilation with each device, including the number of attempts for successful insertion, was noted. A Likert scale questionnaire was filled by each participant indicating the level of confidence, perception of ease, and the ability to provide effective positive pressure ventilation (PPV) with each of the procedures. The paired t-test, chi-square test, and Kruskal-Wallis' test were used for the statistical analysis. RESULTS: Eight (25.8%) out of the 31 participants failed to insert any one of the devices. So, 23 providers were analyzed for the outcomes. We found that the mean duration taken to insert the ETT and LMA was not statistically different (32 vs. 36 seconds). LMA insertion had a higher failure rate compared with ETT. Providers did not perceive confidence to insert LMA when compared with ETT. They did not recognize LMA insertion as a more effortless procedure relative to endotracheal intubation. The providers felt that their ability to provide effective PPV using LMA was inferior to ETT. CONCLUSION: The NRP certified providers in this study did not demonstrate proficiency in the insertion of LMA equivalent to the endotracheal intubation. KEY POINTS:· LMA insertion skill was studied in NRP providers using a manikin.. · Providers had a higher frequency of failure in inserting LMA compared to ETT.. · Providers' perceived confidence and effectiveness of the LMA procedure were inferior to ETT..
journal_name
Am J Perinatoljournal_title
American journal of perinatologyauthors
Mani S,Rawat Mdoi
10.1055/s-0040-1721379subject
Has Abstractpub_date
2020-11-29 00:00:00eissn
0735-1631issn
1098-8785pub_type
杂志文章abstract::Aim To determine the challenges, if any, in translating the benefits of surfactant replacement therapy (SRT) to a resource-limited setting. Method This was a retrospective descriptive study comparing the outcome of 75 cases who received surfactant and 69 controls who did not at the University Hospital of the West Indi...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0036-1598023
更新日期:2017-07-01 00:00:00
abstract::Prematurity, the major cause of perinatal morbidity and mortality, results from a multifactorial interaction of medical, historic, and psychosocial conditions. Although the literature contains several reports of prematurity risk-scoring systems, the relative importance of specific risk factors may depend on the popula...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999893
更新日期:1986-10-01 00:00:00
abstract::We tabulated the incidence of necrotizing enterocolitis (NEC) during a recent 4-year period among three neonatal intensive care units (NICUs) within a single health-care system. We then sought associations to explain differences in NEC incidence between the centers. Between January 1, 2002, and December 31, 2005, 6787...
journal_title:American journal of perinatology
pub_type: 杂志文章,多中心研究
doi:10.1055/s-2007-995220
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study is to examine the hypothesis that prolonged rupture of membranes (PROM) is associated with increased cord blood erythropoietin (EPO) concentrations, proportional to the duration of ruptured membranes. STUDY DESIGN:This study is a prospective, cross-sectional, observational (nonintervent...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0034-1384643
更新日期:2015-03-01 00:00:00
abstract::Surfactants have been routinely used since 1990 for the treatment of respiratory distress syndrome (RDS). The use of surfactant has coincided with a decrease in mortality in infants due to RDS. This review focuses on clinical aspects of surfactant use. New information, particularly effects of ventilatory styles on sur...
journal_title:American journal of perinatology
pub_type: 杂志文章,评审
doi:10.1055/s-2000-13445
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Bacillus Calmette-Guerin (BCG) scar formation is considered a visual marker of vaccination and cell-mediated immune response. This study characterized the association between pregnancy and birth characteristics with BCG scar formation. STUDY DESIGN:Pregnant women were enrolled prospectively. Infants were fo...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1676614
更新日期:2019-10-01 00:00:00
abstract::Previous work has shown that fetal hydrographic magnetic resonance imaging (MRI) provided additional information complementary to T2-weighted single-shot fast spin echo (ssFSE) images. The objective of this study was to determine if hydrographic MRI provides better conspicuity of fetal eye structures compared with ssF...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0031-1295636
更新日期:2012-04-01 00:00:00
abstract::It is well established that ultrasound measurement of femur length and biparietal diameter are comparably accurate estimators of gestational age when obtained in the first half of pregnancy. Both estimators, however, become less accurate later in pregnancy. The present study compares the relative accuracy of these est...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-999837
更新日期:1986-04-01 00:00:00
abstract::Fetal exposure to infection and inflammation can result in accelerated lung maturation and simultaneously altered lung development. This alteration is characterized by reduced alveolar and vascular formation that is one of the hallmarks of the changes observed in animal models and in infants with bronchopulmonary dysp...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1714347
更新日期:2020-09-01 00:00:00
abstract:: ...
journal_title:American journal of perinatology
pub_type: 社论
doi:10.1055/s-0038-1676585
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:Our objective was to evaluate the efficacy of perioperative multimodal pain management in reducing opioid use after elective cesarean delivery (CD). STUDY DESIGN:A single-center, double-blinded, placebo-controlled randomized trial of women undergoing elective CD. Participants were allocated 1:1 to receive th...
journal_title:American journal of perinatology
pub_type: 杂志文章,随机对照试验
doi:10.1055/s-0039-1681096
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE: The purpose of this study was to compare the nulliparous-term-singleton-vertex (NTSV) and the Society of Maternal-Fetal Medicine (SMFM) cesarean birth metrics as tools for quality improvement efforts based on hospital size. MATERIALS AND METHODS: Cesarean birth rates from 275 hospitals from six states were ...
journal_title:American journal of perinatology
pub_type: 杂志文章,多中心研究
doi:10.1055/s-0037-1607985
更新日期:2018-03-01 00:00:00
abstract::The objective of this paper was to determine if routine postpartum hemoglobin (Hb) determination changes patient management. One thousand patients with a vaginal delivery at Hermann Hospital, Houston, TX, had antepartum Hb testing, and a postpartum Hb for: (1) an antepartum Hb <9.0 mg/dL, (2) an estimated blood loss (...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-993881
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the interobserver reliability of fetal heart rate (FHR) pattern definition and interpretation assessed by physicians at various levels of training using standard Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) definitions and standard principles of interpret...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0032-1326991
更新日期:2013-06-01 00:00:00
abstract:: ...
journal_title:American journal of perinatology
pub_type: 杂志文章,已发布勘误
doi:10.1055/s-0038-1660792
更新日期:2018-07-01 00:00:00
abstract::In insulin dependent diabetic (IDDM) gestations, fetal pulmonary maturity is delayed in the presence of suboptimal glycemic control. Serum glycosylated hemoglobin (HbA1c) provides a means of assessing glycemic control. We evaluated maternal HbA1c in IDDM pregnancies at term undergoing amniocentesis for lung maturity t...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-993868
更新日期:1999-01-01 00:00:00
abstract::Phosphatidylglycerol (PG) in amniotic fluid was quantitatively measured by thin-layer chromatography (TLC) in 941 amniotic fluid samples and related to the presence or absence of respiratory distress syndrome (RDS) in neonates born within 7 days of the amniocentesis. In 639 case tests with PG 1 nmol/ml or more of amni...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-994666
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate obstetric outcomes in relation to the extent of donor sperm exposure with and without egg donation. MATERIALS AND METHODS:This is a retrospective cohort study in a single tertiary care center. All women with a singleton pregnancy who conceived following sperm donation (S...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1667029
更新日期:2019-01-01 00:00:00
abstract::Although mother's milk is the optimal nutrition for preterm infants, the amount of protein, calcium, and phosphorus become inadequate for the growth of preterm infants, such that fortification is recommended when enteral feeding is established. Recently, intestinal obstruction due to calcium soap formation has been re...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0031-1295659
更新日期:2012-04-01 00:00:00
abstract::We evaluated the efficacy, safety, and biological mechanisms of digoxin immune Fab (DIF) treatment of severe preeclampsia. Fifty-one severe preeclamptic patients were randomized in double-blind fashion to DIF ( N = 24) or placebo ( N = 27) for 48 hours. Primary outcomes were change in creatinine clearance (CrCl) at 24...
journal_title:American journal of perinatology
pub_type: 杂志文章,随机对照试验
doi:10.1055/s-0030-1249762
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to estimate the contemporary national rate of severe maternal morbidity (SMM) and its associated hospital cost during delivery hospitalization. STUDY DESIGN:We conducted a retrospective study identifying all delivery hospitalizations in the United States between 2011 and 2012....
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0038-1649481
更新日期:2018-11-01 00:00:00
abstract::Our objective was to determine if sonographic estimate of fetal weight (SEFW) can identify fetal growth restriction (FGR; birthweight < 10% for gestational age [GA]) among patients with preterm (28 to 32 weeks) severe preeclampsia (P SPE). At two centers, all singletons with reliable GA, P SPE, and SEFW within 3 weeks...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2008-1075034
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVE: This study aimed to identify differences in sequential integrated screening and early ultrasound markers in monochorionic/diamniotic (MC/DA) pregnancies complicated by twin-to-twin transfusion syndrome (TTTS) and unequal placental sharing (UPS). STUDY DESIGN: Retrospective cohort study of MC/DA pregnancies ...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0040-1718371
更新日期:2020-10-08 00:00:00
abstract::Premature birth before 37 weeks of gestation is a significant public health problem. Each year, 4.5 million premature infants are born worldwide. Despite extensive research and a variety of interventions, the rate of preterm birth has steadily increased over the past 20 years and reached a high of 12.8% in 2006. The e...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2008-1061497
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVE: The objective of this study was to determine predictors of health care utilization and its association with neurodevelopmental outcome in a recent cohort of preterm infants. STUDY DESIGN: A total of 405 infants (born 2008-2011) seen in neonatal intensive care unit (NICU) follow-up were compared for use of h...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0037-1608678
更新日期:2018-04-01 00:00:00
abstract::Brucellosis represents a rare cause of neonatal infection. In this article we report a very unusual case of congenital infection due to BRUCELLA MELITENSIS in a term neonate presenting after birth with severe respiratory distress and radiological manifestations (lobar consolidation and diffuse interstitial infiltratio...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-984407
更新日期:2007-08-01 00:00:00
abstract::The numbers of ectopic pregnancies have increased because of the popularization of assisted reproductive techniques. However, the retroperitoneal space is an exceptional location for ectopic pregnancy because the entrance to the retroperitoneal space is unknown. A woman 31 years of age who had received bilateral salpi...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2007-1004829
更新日期:2008-01-01 00:00:00
abstract::Objective There is limited data regarding the use of oral hypoglycemic agents (OHAs) in pregnant women with type 2 diabetes mellitus (T2DM). Study Design This was a retrospective cohort study of women with T2DM who were treated with OHA or insulin from the first trimester onward. Bivariate and multivariate logistic re...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-0036-1597625
更新日期:2017-06-01 00:00:00
abstract::The objective of this article is to report obstetric outcomes of human immunodeficiency virus-1 (HIV-1)-serodiscordant couples who underwent in vitro fertilization and embryo transfer (IVF-ET) with intracytoplasmic sperm injection (ICSI) at a tertiary care center. We reviewed the outcomes of seronegative women after I...
journal_title:American journal of perinatology
pub_type: 杂志文章
doi:10.1055/s-2003-42694
更新日期:2003-08-01 00:00:00
abstract::The objective of this article is to prospectively investigate the efficacy of amnioinfusion as a means to reduce febrile morbidity in pregnancies complicated by chorioamnionitis. All laboring patients with a temperature > or =100.1 degrees F were approached for study participation. Exclusion criteria included amnionit...
journal_title:American journal of perinatology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1055/s-2007-994085
更新日期:1998-01-01 00:00:00