Supplementary Material for: Laryngeal mask airway in neonatal resuscitation: a survey of the Union of European Neonatal and Perinatal Societies (UENPS)

Introduction: Laryngeal mask airway (LMA) use in neonatal resuscitation is limited despite existing evidence and recommendations. This survey investigated knowledge and experience of healthcare providers on the use of the LMA, and explored barriers and solutions for implementation.
Methods: This online, cross-sectional survey on LMA in neonatal resuscitation involved healthcare professionals of the Union of European Neonatal and Perinatal Societies (UENPS).
Results: 858 healthcare professionals from 42 countries participated in the survey. Only 6% took part in an LMA-specific course. Some delivery rooms were not equipped with LMA (26.1%). LMA was mainly considered after failure of facemask (FM) or endotracheal tube (ET), while the first choice was limited to neonates with upper airway malformations. LMA and FM were considered easier to position but less effective than ET, while LMA was considered less invasive than ET but more invasive than FM. Participants felt less competent and experienced with LMA than FM and ET. The lack of confidence about LMA was perceived as the main barrier to implementation in neonatal resuscitation. More training, supervision, and device availability in delivery wards were suggested as possible actions to overcome those barriers.
Conclusion: Our survey confirms previous findings on limited knowledge, experience, and confidence with LMA, which is usually considered an option after the failure of FM/ET. Our findings highlight the need for increasing the availability of LMA in the delivery wards. Moreover, increasing LMA training and having an LMA-expert supervisor during clinical practice may improve the implementation of LMA use in neonatal clinical practice.

引言：尽管已有相关研究证据与临床推荐，但喉罩气道（Laryngeal mask airway，LMA）在新生儿复苏中的应用仍较为受限。本调查旨在调研医护人员对喉罩气道的认知水平与使用经验，并探讨其临床推广所面临的障碍及解决方案。
方法：本项针对新生儿复苏中喉罩气道应用的线上横断面调查，纳入了欧洲新生儿与围产期医学协会联盟（Union of European Neonatal and Perinatal Societies，UENPS）的医护人员。
结果：共有来自42个国家的858名医护人员参与本次调查。其中仅6%的参与者接受过喉罩气道专项培训。部分产房未配备喉罩气道设备（占比26.1%）。临床实践中，喉罩气道通常仅在面罩（facemask，FM）或气管导管（endotracheal tube，ET）通气失败后才被考虑使用，且其首选应用场景仅限于存在上气道畸形的新生儿。与会者认为，喉罩气道与面罩的置入操作相较于气管导管更为简便，但通气效果稍逊；同时，喉罩气道的侵入性低于气管导管，但高于面罩。参与者对喉罩气道的操作熟练度与临床经验均不及面罩与气管导管。对喉罩气道使用缺乏信心，被认为是其在新生儿复苏中推广的主要障碍。与会者建议，可通过增加专项培训、加强临床督导以及提升产房内喉罩气道设备的可及性来克服上述障碍。
结论：本调查证实了既往研究结论，即医护人员对喉罩气道的认知、使用经验与信心均存在不足，且其通常仅被作为面罩/气管导管通气失败后的备选方案。本研究结果凸显了提升产房内喉罩气道设备可及性的必要性。此外，加强喉罩气道专项培训，并在临床实践中配备喉罩气道专家督导，或可改善喉罩气道在新生儿临床实践中的推广应用。