Management of neonatal difficult airway emergencies in the delivery room

Neonatal airway emergencies in the delivery room are associated with significant morbidity and mortality. Etiologies vary, but often predispose the neonate to life threatening airway obstruction. With the recent expansion of fetal medicine programs, pediatric anesthesiologists are increasingly being asked to care for these patients. In this review, we discuss common etiologies of difficult airway at delivery, management tools and techniques, and surgical approaches.

[1]  L. Devisme,et al.  Histoanatomical structures of laryngeal atresia: Functional considerations , 2020, The Laryngoscope.

[2]  G. Demirel,et al.  High Flow Nasal Cannula versus Nasal Continuous Positive Airway Pressure for Primary Respiratory Support in Preterm Infants: A Prospective Randomized Study , 2019, American Journal of Perinatology.

[3]  D. Braude,et al.  Apneic nasal oxygenation and safe apnea time during pediatric intubations by learners , 2019, Paediatric anaesthesia.

[4]  B. Tsui,et al.  The successful application of high flow nasal oxygen during microdirect laryngoscopy and bronchoscopy in patients under 7 kg. , 2019, Journal of clinical anesthesia.

[5]  V. Nadkarni,et al.  Neonatal Intubation Practice and Outcomes: An International Registry Study , 2018, Pediatrics.

[6]  M. Kumar,et al.  Laryngeal mask airway versus bag-mask ventilation or endotracheal intubation for neonatal resuscitation. , 2018, The Cochrane database of systematic reviews.

[7]  P. Argente Navarro,et al.  Emergency Ventilation of Infant Subglottic Stenosis Through Small-Gauge Lumen Using the Ventrain: A Case Report , 2017, A&A practice.

[8]  Jorge A. Gálvez,et al.  The efficacy of GlideScope® videolaryngoscopy compared with direct laryngoscopy in children who are difficult to intubate: an analysis from the paediatric difficult intubation registry , 2017, British journal of anaesthesia.

[9]  A. Nishisaki,et al.  Videolaryngoscopy versus Fiber-optic Intubation through a Supraglottic Airway in Children with a Difficult Airway: An Analysis from the Multicenter Pediatric Difficult Intubation Registry , 2017, Anesthesiology.

[10]  D. Rosen,et al.  Nasal high‐flow oxygen delivery in children with abnormal airways , 2017, Paediatric anaesthesia.

[11]  S. Heinrich,et al.  Comparison of Metal and Plastic Disposable Laryngoscope Blade with Reusable Macintosh Blade in Difficult and Inhalation Injury Airway Scenario: A Manikin Study. , 2017, The Journal of emergency medicine.

[12]  T. Crombleholme,et al.  Airway compromise in the fetus and neonate: Prenatal assessment and perinatal management. , 2016, Seminars in fetal & neonatal medicine.

[13]  Elaina E. Lin,et al.  Anesthetic Management of 65 Cases of Ex Utero Intrapartum Therapy: A 13-Year Single-Center Experience , 2016, Anesthesia and analgesia.

[14]  S. Tharakan,et al.  Immediate operative management of the fetus with airway anomalies resulting from congenital malformations. , 2016, Seminars in fetal & neonatal medicine.

[15]  S. Vijayasekaran,et al.  Airway disorders of the fetus and neonate: An overview. , 2016, Seminars in fetal & neonatal medicine.

[16]  C. Zdanski,et al.  Emergent airway management in the labor and delivery suite. , 2016, International journal of pediatric otorhinolaryngology.

[17]  F. Fynn-Thompson,et al.  A Modified EXIT-to-ECMO with Optional Reservoir Circuit for Use during an EXIT Procedure Requiring Thoracic Surgery. , 2016, The journal of extra-corporeal technology.

[18]  V. Nadkarni,et al.  Airway management complications in children with difficult tracheal intubation from the Pediatric Difficult Intubation (PeDI) registry: a prospective cohort analysis. , 2016, The Lancet. Respiratory medicine.

[19]  P. Walz,et al.  Prenatal diagnosis of obstructive head and neck masses and perinatal airway management: the ex utero intrapartum treatment procedure. , 2015, Otolaryngologic clinics of North America.

[20]  J. Fiadjoe,et al.  Anesthesia Challenges for the Difficult and Critical Neonatal Airway , 2015 .

[21]  S. Andreoli,et al.  Malformations, Deformations, and Disorders of the Neonatal Airway: A Bullet Point Review , 2015 .

[22]  C. Derkay,et al.  Evaluation of the Neonatal Airway: Laryngoscopy and Bronchoscopy , 2015 .

[23]  H. Hedrick,et al.  Operative Surgical Management of Fetuses with CHAOS: Management at Delivery , 2015 .

[24]  L. Javia,et al.  Craniofacial Syndromes with Airway Anomalies: An Overview , 2015 .

[25]  Jesse A. Taylor,et al.  Impact of Micro- and Retrognathia on the Neonatal Airway , 2015 .

[26]  Alexis Battista,et al.  The simulation of an ex utero intrapartum procedure to extracorporeal membrane oxygenation. , 2011, Journal of pediatric surgery.

[27]  K. Saxena,et al.  Right molar approach to tracheal intubation in a child with Pierre Robin syndrome, cleft palate, and tongue tie. , 2008, British journal of anaesthesia.

[28]  A. Wilkes,et al.  User satisfaction and forces generated during laryngoscopy using disposable Miller blades: a manikin study * , 2007, Anaesthesia.

[29]  P. Farrell Prenatal diagnosis and intrapartum management of neck masses causing airway obstruction , 2004, Paediatric anaesthesia.

[30]  M. Morgan,et al.  Intrapartum airway management for giant fetal neck masses: the EXIT (ex utero intrapartum treatment) procedure. , 1997, American journal of obstetrics and gynecology.