The incidence of difficult direct laryngoscopy is higher in patients younger than one versus older patients.1 In neonates with an anticipated or unanticipated difficult airway, a laryngeal mask airway (LMA) is an acceptable temporary airway, because management with an LMA in neonates has been shown to be successful and safe.2 After stabilization with an LMA, securing the airway with an endotracheal tube (ETT) becomes paramount.
Although an LMA Unique size 1 (Laryngeal Mask Company Limited, USA) has a limited internal diameter, an uncuffed 2.5-mm or 3-mm ETT will fit inside (fig, panel A). An LMA Unique size 1 is only a few centimeters shorter than an uncuffed 2.5-mm ETT, so advancing the ETT into the trachea through the LMA is impossible without assistance. Devices like the Aintree Intubation Catheter (Cook Critical Care, USA) are too big for this patient population,3 and, although an air-Q LMA...
