Doctoral thesis sheds light on neonatal resuscitation in Vietnam and innovative airway solutions
Every year, hundreds of thousands of newborns die from preventable complications during birth. A new doctoral thesis examines neonatal resuscitation practices in Vietnam and introduces innovative airway solutions that could save lives worldwide.
More than half a million newborns die from intrapartum-related hypoxic events (insufficient oxygen supply during labor) each year – many of them preventable with timely and effective resuscitation. A new doctoral thesis, “Surviving birth: resuscitation practice in Vietnam and the development of a supraglottic airway device” by Tina Dempsey, explores this critical challenge and proposes innovative solutions.
Her research combines observational studies in Vietnam with anatomical feasibility studies in Sweden. It shows that traditional airway management methods, such as face mask ventilation and endotracheal intubation, often fail or need repeated attempts before being successfully placed – particularly for low-birth-weight infants. To address this, the thesis evaluates smaller prototypes of the i-gel® supraglottic airway device, showing promising results for improving neonatal resuscitation globally.
“Taken together, this thesis helps shift the perspective from device performance under ideal conditions to the pragmatic question of which devices are most likely to improve neonatal outcomes in the environments where the majority of preventable deaths occur,” says Tina Dempsey.
Promising results with smaller airway devices
In Tina Dempsey’s first paper of the thesis, she examined the incidence of intrapartum-related events at Hanoi’s largest obstetric hospital. It found that while positive pressure ventilation was needed in only 0.4–0.6% of births, low birth weight significantly increased the risk of resuscitation. This provided crucial baseline data for neonatal care in Vietnam.
In Paper II, the focus was on endotracheal intubation performance in delivery rooms. The study showed repeated attempts, especially in smaller infants, which often exceeded recommended safety limits. These findings led to the conclusion that simpler airway alternatives are urgently needed.
Paper III explored whether smaller supraglottic airway prototypes could fit low-birth-weight neonates. Radiologic evaluations showed that sizes 0.85 and 0.75 worked well for babies weighing 900–2,250 g, paving the way for new device development.
These results were validated in paper IV using CT scans of stillborn neonates. The prototypes demonstrated promising anatomical fit, reinforcing their potential for clinical use and highlighting the next steps toward implementation.
Tina Dempsey’s work underscores the need for accessible, effective airway devices in low-resource settings and positions supraglottic airways as a promising solution to reduce preventable neonatal deaths worldwide. In addition to improving survival rates, it is crucial to examine how these interventions affect long-term development.
“Addressing neurodevelopmental follow-up at 18 months in future research is essential to fully evaluate the supraglottic airway device in comparison to the face mask and the endotracheal tube. Without such data, we do not fully understand the lasting impact of resuscitation interventions beyond immediate survival and short-term clinical outcomes,” Tina Dempsey concludes.
Tina Dempsey successfully defended her doctoral thesis 21 November 2025 at Karolinska Institutet
Opponent at the thesis defence was Associate Professor Nick Brown, Department of Women's and Children's Health, Uppsala University
Examination Board:
Associate Professor Ashish Kc, School of Public Health and Community Medicine, University of Gothenburg
Professor Britt Gustafsson, CLINTEC, Karolinska Institutet
Professor Richard Sindelar, Department of Women's and Children's Health, Uppsala University
Tina Dempsey's main supervisor: Professor Tobias Alfvén, Department of Global Public Health, Karolinska Institutet
Co-supervisors:
Dr. Susanna Myrnerts Höök, GPH, Karolinska Institutet
Dr. Nicolas Pejovic, GPH, Karolinska Institutet
Professor Mats Blennow, CLINTEC, Karolinska Institutet