Airway manoeuvres to achieve upper airway patency during mask ventilation in newborn infants – An historical perspective

Abstract

Maintenance of upper airway patency remains a cornerstone of adequate airway management. Although various opening manoeuvres are recommended by neonatal resuscitation guidelines, none of these have been well evaluated in newly born infants.The aim of this article was to review the available literature about airway opening manoeuvres in newborn infants. We reviewed books, resuscitation manuals and articles from 1860 to the present with the search terms “Infant, Newborn”, “airway management”, “airway manoeuvres”, “chin lift”, “jaw thrust”, “neutral position”, “shoulder roll”, “neonatal resuscitation”, “positive pressure respiration” and “continuous positive airway pressure”. Only human studies were included.During mask PPV, jaw thrust appears to be more effective in achieving a patent upper airway and might help to reduce airway obstruction. The additional application of chin lift might reduce leak during mask ventilation. However given the lack of available data these conclusions remains speculative and further research in this area is required.