Title:Use and Efficacy of I-gel in Complicated Intubations in Newborn Infants: A Review of Case Reports in the Literature
Volume: 21
Issue: 1
Author(s): Emiliano Barbieri*, Maurizio Giordano, Giuseppe Sorgente, Giulia Borgia, Marta Improta, Monica Colonna, Valeria Crisci, Valentina Fattorusso, Flavia Barbieri, Giuseppe Buonocore and Giuseppe De Bernardo
Affiliation:
- Division of Pediatrics, Department of Transaltional Medical Sciences, University of Naples "Federico II", Naples, Italy
Keywords:
I-gel, laryngeal mask, anatomical abnormalities, difficult intubation, gestation age, newborn.
Abstract:
Introduction: Current guidelines for neonatal resuscitation suggest the use of a laryngeal
mask when ventilation with both facemask and endotracheal tube has failed in newborns
weighing >2000 g or delivered ≥ 34 weeks of gestation age. Paediatric I-gel® is one of the latest
supraglottic airway management devices suitable for children and newborns. I-gel® use was effective
in guaranteeing adequate ventilation in patients with anatomic abnormalities in case of respiratory
impairment or during surgical procedures after the induction of anaesthesia.
Objective: The purpose of our review was to evaluate the use and efficacy of I-gel® in case of complicated
intubations.
Methods: In July 2023, two authors of this paper independently conducted searches of the MEDLINE,
Web of Science, and Scopus databases without imposing any time constraints or other restrictions.
Three case reports were included, each describing the use of I-gel® device in difficult intubations
in newborns with anatomical abnormalities.
Results: No difficulties were reported in the insertion of the device, which was placed even by inexperienced
clinicians.
Conclusion: The data collected highlighted the possibility of using I-gel® not only as a rescue device
after attempted and failed endotracheal placement but also as a first choice in selected patients.
Studies on larger cohorts would be needed. Further research involving larger patient cohorts
of multicentre NICUs is necessary to confirm the use of laryngeal masks in neonates weighing
less than 2000 grams.
