Use of the LMA classic to secure the airway of a premature neonate with Smith-Lemli-Opitz syndrome: a case report.

In addition to managing the most challenging of airways within the operating room environment, anesthesia providers are frequently consulted or requested to participate in emergency airway control in various areas of the hospital, often after other providers have failed. The following is a case report of a premature infant born with multiple and life threatening congenital anomalies in a rural facility. The current recommendations of the American Heart Association for neonatal resuscitation were followed; however, the resuscitating team was unable to secure the airway using standard intubating techniques. Consultation with the anesthetist on duty resulted in the successful placement of the laryngeal mask airway (LMA) size 1. The pediatrician involved in the care of the patient had minimal experience with using the LMA; however, with verbal instruction was able to successfully place the LMA. With a patent airway established, the patient stabilized and was transferred to a tertiary facility for aggressive care. Although currently not part of the American Heart Association neonatal resuscitation algorithm, consideration of the LMA as a tool to manage an airway after failed attempts at intubation may be appropriate.