The size 1 LMA-ProSeal (TM): Comparison with the LMA-Classic (TM) during pressure controlled ventilation in a neonatal intubation manikin

Background: The classic laryngeal mask airwayTM (cLMA) has been demonstrated to be effective for airway management during neonatal resuscitation. However, high airway pressures, when required, cannot be achieved with this device. A neonatal prototype of the LMA-ProSealTM (PLMA), which might improve the oropharyngeal leak pressure, has recently been produced. The airway sealing pressures of the cLMA and the PLMA were compared in a neonatal manikin. Methods: A neonatal PLMA and a neonatal cLMA were positioned at random in a neonatal intubation manikin (Neonate Airway Trainer; Laerdal, Norway). A Dr¨ aeger pressure controlled ventilator (Dr¨ aeger 8000; Dr¨ aegerwerk AG, Germany) was con- nected to the airway tubes and increasing inspiratory pressures (from 10 to 40 cm H2 O) of positive pressure ventilation applied. The peak and the mean airway pres- sures obtained with each device were recorded. Results: The airway pressures obtained with PLMA were significantly higher than those obtained with cLMA (p < 0.01) at levels of positive pressure ventilation of 25, 30, 35 and 40 cm H2 O. Conclusions: The neonatal PLMA allows higher airway pressure ventilation than the cLMA, in a neonatal intubation manikin. If confirmed clinically, this may have important implications during neonatal resuscitation when high airway pressures are required.