Frontiers in pediatrics · 2026
The AerVia supraglottic airway device versus the endotracheal tube in neonatal delivery room resuscitation: a prospective cohort study.
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Abu Lehyah Naser Aldain A, Abusabha Alaa M, Hasan Abeer A, Al-Qaryouti Rahaf A, Shersheer Qasem A, Cummings James J, Guthrie Scott O
Аннотация
OBJECTIVE: To evaluate a supraglottic airway device (SAD) as an alternative to the endotracheal tube (ETT) in infants requiring resuscitation in the delivery room.
STUDY DESIGN: Newborns requiring resuscitation beyond face mask ventilation due to inadequate ventilation or persistent bradycardia at Al Bashir Hospital in Amman, Jordan, were resuscitated using the AerVia SAD (n = 73) and compared with a historic cohort resuscitated by the ETT (n = 80).
RESULTS: AerVia and ETT cohorts had similar mean gestational age (32.0 ± 2.8 vs. 32.7 ± 2.3 weeks, p = 0.13) and birth weight (1.63 ± 0.44 vs. 1.68 ± 0.37 kg, p = 0.48). Although several comparisons demonstrated clinically important differences favoring the AerVia SAD, not all reached conventional statistical significance. First-attempt success was higher for AerVia than for the ETT (99% vs. 90%, p = 0.055). AerVia placement required fewer attempts (1.0 ± 0.1 vs. 1.1 ± 0.3, p = 0.07), was faster (9 ± 2 vs. 11 ± 3 s, p = 0.001), and resulted in comparable return of spontaneous breathing (45 ± 12 vs. 42 ± 8 s, p = 0.07). In a multivariate analysis, use of an SAD was associated with increased odds of first-attempt success compared with the ETT (adjusted odds ratio 9.28, 95% CI 0.89-96.76, p = 0.063). Complication rates were comparable for AerVia (18% vs. 23%, p = 0.55); the most common complication in the AerVia cohort was mild abdominal distension (N = 6) and in the ETT cohort airway trauma (N = 12). Eighty-three infants were <34 weeks' gestation (AerVia = 47, ETT = 36), and comparisons in this subgroup were similar.
CONCLUSION: The AerVia SAD was associated with less airway trauma compared with the ETT. Although placement appeared faster and required fewer attempts, these differences did not reach statistical significance. SADs appear to be a reasonable alternative to an ETT for advanced neonatal resuscitation in the delivery room. Our findings suggest that appropriately sized neonatal SADs may also be feasible in selected infants born <34 weeks' gestation and support further studies.
STUDY DESIGN: Newborns requiring resuscitation beyond face mask ventilation due to inadequate ventilation or persistent bradycardia at Al Bashir Hospital in Amman, Jordan, were resuscitated using the AerVia SAD (n = 73) and compared with a historic cohort resuscitated by the ETT (n = 80).
RESULTS: AerVia and ETT cohorts had similar mean gestational age (32.0 ± 2.8 vs. 32.7 ± 2.3 weeks, p = 0.13) and birth weight (1.63 ± 0.44 vs. 1.68 ± 0.37 kg, p = 0.48). Although several comparisons demonstrated clinically important differences favoring the AerVia SAD, not all reached conventional statistical significance. First-attempt success was higher for AerVia than for the ETT (99% vs. 90%, p = 0.055). AerVia placement required fewer attempts (1.0 ± 0.1 vs. 1.1 ± 0.3, p = 0.07), was faster (9 ± 2 vs. 11 ± 3 s, p = 0.001), and resulted in comparable return of spontaneous breathing (45 ± 12 vs. 42 ± 8 s, p = 0.07). In a multivariate analysis, use of an SAD was associated with increased odds of first-attempt success compared with the ETT (adjusted odds ratio 9.28, 95% CI 0.89-96.76, p = 0.063). Complication rates were comparable for AerVia (18% vs. 23%, p = 0.55); the most common complication in the AerVia cohort was mild abdominal distension (N = 6) and in the ETT cohort airway trauma (N = 12). Eighty-three infants were <34 weeks' gestation (AerVia = 47, ETT = 36), and comparisons in this subgroup were similar.
CONCLUSION: The AerVia SAD was associated with less airway trauma compared with the ETT. Although placement appeared faster and required fewer attempts, these differences did not reach statistical significance. SADs appear to be a reasonable alternative to an ETT for advanced neonatal resuscitation in the delivery room. Our findings suggest that appropriately sized neonatal SADs may also be feasible in selected infants born <34 weeks' gestation and support further studies.