Reproductive health, child health and nutrition
research project

Laryngeal mask vs. bag-mask ventilation in neonatal resuscitation, Uganda

Providing effective ventilation is extremely important in successful neonatal resuscitation, but doing this with a mask requires high skills and continuous training. Observations indicate that the newest laryngeal masks are easier to use for untrained staff, thus reducing the risk of birth asphyxia.

Main content

Full Project title:            
Randomized clinical trial assessing laryngeal mask (LMA) versus bag-mask ventilation in neonatal resuscitation in Uganda

Project coordinator:
Thorkild Tylleskär, Centre for International Health, UiB, Norway

Jolly Nankunda, Mulago Hospital, Kampala, Uganda
Nicolas Pejovic, Center for Education in Paediatric Simulation (CEPS), Sachs's Children's Hospital, Stockholm

The Laerdal Foundation for Acute Medicine

Objective:  To compare the use of LMA vs. bag-mask ventilation during neonatal resuscitation in Mulago Hospital, Kampala, Uganda

Background and project description

Providing effective positive pressure ventilation is the single most important component of successful neonatal resuscitation. Ventilation is frequently initiated with a manual resuscitation bag and face-mask (BMV) followed by endotracheal intubation (ETT) if depression continues. These techniques may be difficult to perform successfully resulting in prolonged resuscitation or severe neonatal depression.

The laryngeal mask airway (LMA) may achieve initial ventilation and successful resuscitation faster than a bag-mask device or ETT. The latest generation of LMA is made of a high grade gel-like elastomer designed to provide and efficient seal to the larynx without an inflatable cuff and with very little risk for trauma. Insertion is easy with low risk of tissue compression or dislodgement.

In order to impact Millennium Development Goals 4 it is crucial to explore alternative, cost-effective modalities that not only would reduce mortality, but also the burden of neurological damage in survivors.

The study will be carried out in Mulago Hospital, the National Referral and Teaching Hospital in Kampala, Uganda with 1800 deliveries per month. Of these babies, 5-10% will need moderate to extensive resuscitation. This randomized trial will include all babies eligible for resuscitation. Mother’s consent will be obtained prior to the final stage of labor.