Success of Laryngeal Mask Airway (LMA) Insertion During Continuous Chest Compressions in Neonatal Resuscitation: A Randomized Crossover Simulation Study

The purpose of this study is to evaluate the time required for laryngeal mask airway (LMA) insertion, first-attempt success rates, and airway sealing quality (air leak) during neonatal resuscitation with and without interrupting chest compressions. Standard resuscitation guidelines recommend pausing chest compressions for airway interventions due to the difficulty of inserting devices during physical movement. However, interrupting compressions drops coronary and cerebral perfusion. This study tests whether an LMA can be successfully inserted without pausing compressions in a high-fidelity simulation model. A total of 32 anesthesiologists participate in this randomized, crossover simulation study using a high-fidelity neonatal manikin. Participants perform two different scenarios in a randomly allocated order: Scenario A involves standard LMA insertion with interrupted chest compressions, and Scenario B involves LMA insertion during continuous, uninterrupted chest compressions. The primary objective is to determine if performing the procedure under continuous chest compressions affects the procedure time, clinical success, air leak volumes, or the perceived workload and stress of the practitioners.

Study Overview

• Status: Completed
• Conditions: Airway Management; Asphyxia Neonatorum; Neonatal Resuscitation; Cardiopulmonary Resuscitation (CPR)
• Intervention / Treatment: Device: Size 1 ProSeal™ LMA

• Study Type: Interventional
• Enrollment (Actual): 32
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Kahramanmaraş
    • Kahramanmaraş, Kahramanmaraş, Turkey (Türkiye), 46100
      • Kahramanmaraş Sütçü İmam University, Faculty of Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. Being a senior anesthesiology resident (completed 2nd year) or an attending anesthesiologist.
2. Voluntary participation with signed informed consent.

Exclusion Criteria:

1. Refusal to participate.
2. Major physical disability that limits psychomotor tasks.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Group 1 (Scenario A -> B); Participants perform traditional LMA insertion with interrupted chest compressions first (Scenario A), followed by a 10-minute washout period, and then perform LMA insertion under continuous chest compressions (Scenario B).	Device: Size 1 ProSeal™ LMA; Laryngeal Mask Airway used for neonatal ventilation simulation.
Experimental: Group 2 (Scenario B -> A); Participants perform LMA insertion under continuous chest compressions first (Scenario B), followed by a 10-minute washout period, and then perform traditional LMA insertion with interrupted chest compressions (Scenario A).	Device: Size 1 ProSeal™ LMA; Laryngeal Mask Airway used for neonatal ventilation simulation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
LMA Insertion Time	The time (in seconds) elapsed from the moment the participant picks up the LMA until the device is seated in the anatomical position and the first lung ventilation is achieved.	Periprocedural

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
First-attempt insertion success rate	Percentage of participants succeeding on the first try	Periprocedural
Measured Air Leak Volume	Measured Air Leak Volume (L/min) during 1-minute ventilation.	1 minute post-procedure
Perceived Procedural Difficulty	Measured via Visual Analogue Scale - VAS, 0 to 10	Immediate post-procedure

Collaborators and Investigators

• Sponsor: Kahramanmaras Sutcu Imam University

Study record dates

Study Major Dates

• Study Start (Actual): June 23, 2026
• Primary Completion (Actual): June 24, 2026
• Study Completion (Actual): June 24, 2026

Study Registration Dates

• First Submitted: June 26, 2026
• First Submitted That Met QC Criteria: July 1, 2026
• First Posted (Actual): July 2, 2026

Study Record Updates

• Last Update Posted (Actual): July 2, 2026
• Last Update Submitted That Met QC Criteria: July 1, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Infant, Newborn, Diseases; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Asphyxia Neonatorum
• Other Study ID Numbers: KSUEK-2026-09

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No