Miklós Szabó

Jun 22, 2024 | nature.com | Attila Szabó |Miklós Szabó |Balázs Hauser |János Gál |Ágnes Jermendy |Lóránt K. Kátai | +5 more

Retinopathy of prematurity is treated with laser photocoagulation under general anaesthesia with intubation using endotracheal tube (ETT), which carries a risk for postoperative mechanical ventilation (MV). Laryngeal mask airway (LMA) may provide a safe alternative. We assessed the need for postoperative MV in preterm infants who received LMA versus ETT. In this single-centre, retrospective cohort study, preterm infants who underwent laser photocoagulation between 2014–2021 were enroled. For airway management, patients received either LMA (n = 224) or ETT (n = 47). The outcome was the rate of postoperative MV. Patients’ age were 37 [35;39] weeks of postmenstrual age, median bodyweight of Group LMA was higher than Group ETT’s (2110 [1800;2780] g versus 1350 [1230;1610] g, respectively, p < 0.0001). After laser photocoagulation, 8% of Group LMA and 74% of Group ETT left the operating theatre requiring MV. Multiple logistic regression revealed that the use of LMA and every 100 g increase in bodyweight significantly decreased the odds of mechanical ventilation (OR 0.21 [95% CI 0.07–0.60], and 0.73 [95% CI 0.63–0.84], respectively). Propensity score matching confirmed that LMA decreased the odds of postoperative MV (OR 0.30 [95% CI 0.11–0.70]). The use of LMA is associated with a reduced need for postoperative MV.