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Airway management protocol for conjoined twins delivery.

Adam Snoap1, Varun V Varadarajan2, Meredith E Mowitz3

  • 1University of Florida Department of Otolaryngology, 1345 Center Dr, Box #100264, Gainesville, FL, 32610, USA.

International Journal of Pediatric Otorhinolaryngology
|November 27, 2020
PubMed
Summary

Conjoined twin deliveries necessitate a coordinated approach for neonatal airway management. A new protocol standardizes care, improving outcomes for these complex cases.

Keywords:
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Area of Science:

  • Neonatal care
  • Surgical preparation
  • Airway management

Background:

  • Conjoined twin deliveries present unique challenges for neonatal airway management.
  • Existing literature is primarily limited to case reports, highlighting a need for standardized protocols.

Purpose of the Study:

  • To present a case series of conjoined twin deliveries.
  • To introduce and describe a novel airway management protocol for conjoined twin delivery.

Main Methods:

  • Retrospective review of medical records for conjoined twins (April 2016-December 2018).
  • Literature search of the NCBI database for relevant studies on neonatal airway management in conjoined twin deliveries.

Main Results:

  • Five sets of conjoined twins (10 neonates) were analyzed.
  • All neonates required bag valve mask ventilation; 7 needed continuous positive airway pressure, and 6 required endotracheal intubation.
  • No emergent tracheostomies or ex-utero intrapartum treatment were necessary.

Conclusions:

  • Conjoined twin deliveries demand significant multidisciplinary collaboration, particularly from otolaryngologists.
  • Implementing a standardized airway management protocol is crucial for securing neonatal airways and optimizing patient outcomes.