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Airway Emergencies in the Neonate: Preparedness at the Bedside

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Disorders of the Neonatal Airway

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Abstract

Bag mask ventilation has traditionally been used as the mainstay in neonatal resuscitation. The NRP guidelines maintain that positive pressure ventilation is the most important step in newborn resuscitation [13, 39, 62]. However, the recommended use of simple bag mask ventilation can be particularly difficult and, often times, ineffective in newborn infants. In a study of bag mask ventilation of almost 60 very preterm infants under 1 kg, 48 % demonstrated significant mask leak which could only be corrected with repositioning. Inappropriate positioning caused significant airway obstruction 25 % of the time [49]. In another study using colorimetric detectors, airway obstruction occurred in a majority of low birth weight infants receiving bag mask ventilation during resuscitation [13]. Consequently, a well-prepared neonatal unit will have a well-defined process for addressing airway emergencies far beyond the use of bag mask ventilation.

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Author information

Authors and Affiliations

  1. Attending Neonatologist, Attending Neonatologist, Director Neonatal Outreach, Medical Director, Neonatal Airway Program, The Children’s Hospital of Philadelphia, Associate Professor of Clinical Pediatrics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA

    Janet Lioy M.D.

  2. Division of Plastic Surgery, Department of Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    J. Thomas Paliga

  3. Duke University School of Medicine, Philadelphia and Durham, PA & NC, USA

    J. Thomas Paliga

  4. Division of Neonatology, Pulmonary Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Hitesh Deshmuhk M.D.

  5. University of Cincinnati School of Medicine, Cincinnati, OH, USA

    Hitesh Deshmuhk M.D.

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  1. Janet Lioy M.D.
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  3. Hitesh Deshmuhk M.D.
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Correspondence to Janet Lioy M.D. .

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Editors and Affiliations

  1. Attending Neonatologist, Director Neonatal Outreach, Medical Director, Neonatal Airway Program, The Children’s Hospital of Philadelphia, Associate Professor of Clinical Pediatrics, Department of Neonatology, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA

    Janet Lioy

  2. Attending Surgeon, Fellowship Director, Pediatric Otolaryngology, The Center for Pediatric Airway Disorders, The Children’s Hospital of Philadelphia, Associate Professor, Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA

    Steven E. Sobol

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Lioy, J., Paliga, J.T., Deshmuhk, H. (2015). Airway Emergencies in the Neonate: Preparedness at the Bedside. In: Lioy, J., Sobol, S. (eds) Disorders of the Neonatal Airway. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1610-8_27

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  • DOI: https://doi.org/10.1007/978-1-4939-1610-8_27

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