Laryngeal mask: beyond neonatal upper airway malformations

We describe successful rescue airway management with a laryngeal mask airway (LMA) by experienced users in rare ‘can't ventilate/can't intubate’ scenarios in three infants with normal airway anatomy.1 1. A male infant weighing 3.53 kg underwent surgical intervention for intestinal malrotation. Twenty-six hours after the intervention, fentanyl infusion was stopped; the patient was extubated to spontaneous breathing. Twenty minutes later, he presented with apnoea, desaturation and bradycardia. Face mask ventilation (FMV) failed. Therefore, a LMA was inserted obtaining immediate clinical improvement. Naloxone was administered. The LMA was removed 5 min later when the neonate became vigorous and would no longer tolerate it. No further complications were encountered. The patient was discharged in good clinical condition.