Delivery room management of the meconium-stained newborn

Wiswell, Thomas E.

doi:10.1038/jp.2008.143

Cited by 24 publications

(20 citation statements)

References 18 publications

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“…Several studies have observed that despite employing all available current strategies to clear meconium from accessible proximal airways, incidence of MAS continues to remain unaffected. 4 The effectiveness of endotracheal suction in non-vigorous newborns in preventing MAS and associated morbidity has never previously been evaluated in a randomized controlled trial and various guidelines have warranted further studies on this issue. 14,15,19 In addition, the current practice of performing endotracheal suction delays the definitive steps of resuscitation by several seconds and is associated with potential side effects of bradycardia, hoarseness, stridor, apnea etc.…”

Section: Introductionmentioning

confidence: 98%

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Endotracheal suction in term non vigorous meconium stained neonates—A pilot study

et al. 2016

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Section: Introductionmentioning

confidence: 98%

“…3,4 In addition, early onset neonatal seizures, hypotonia and cerebral palsy have been reported in neonates born through MSAF. [5][6][7][8] Abbreviations: MSAF, Meconium stained amniotic fluid; MAS, Meconium aspiration syndrome.…”

Section: Introductionmentioning

confidence: 99%

Endotracheal suction in term non vigorous meconium stained neonates—A pilot study

et al. 2016

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“…8 Of these, nearly half require mechanical ventilation, 15%-20% develop air leaks, and 5%-12% die. 9 An estimated 25,000 to 30,000 cases and 1000 deaths related to MAS occur annually in the USA. 10 A review of ten reports published from 1990 to 1998 showed a combined incidence rate of 13.1% for MSAF, 4.2% of MAS among MSAF, and 49.7% of MAS requiring ventilatory support with 4.6% mortality.…”

Section: Epidemiologymentioning

confidence: 99%

Meconium aspiration syndrome: challenges and solutions

Goel¹,

Nangia²

2017

RRN

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Meconium aspiration syndrome (MAS) is an important cause of morbidity and mortality among term newborns. A result of antepartum or postpartum aspiration of meconium stained amniotic fluid (MSAF), MAS causes respiratory distress of varying severity, often complicated by air leaks or persistent pulmonary hypertension (PPHN). There has been a tremendous change in the concepts of pathophysiology and management of MAS over the last few decades. Routine endotracheal suctioning is no longer recommended in both vigorous and nonvigorous neonates with MSAF. Supportive management, along with newer therapies such as surfactant, inhaled nitric oxide, and high-frequency ventilation, has resulted in marked improvement in the overall outcome of MAS. The present review highlights the challenges in understanding the complex pathophysiology and optimal management approach to MAS. Potential future therapies and drugs in trial are also discussed briefly.

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“…Bei der Hypothermietherapie wird der gesamte Körper auf + 33°C abgekühlt[28].Mekoniumhaltiges Fruchtwasser.Bei etwa 10-15% aller Geburten findet sich mekoniumhaltiges Fruchtwasser. Lediglich 3-4% dieser Neugeborenen haben Mekonium in ihren Atemwegen[37]. Diese können von einer milden Tachydyspnoe, über ein ausgeprägtes Atemnotsyndrom bis hin zu einer schweren pulmonalen Hypertension reichen.…”

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“…Etwa 50% der Kinder benötigen eine mechanische Beatmung, 15-33% entwickeln im Verlauf einen Pneumothorax. Die Mortalität liegt bei 5-12%[37]. Frü-her wurde angenommen, dass es sich bei dem schweren Mekoniumaspirationssyndrom um ein postnatales Ereignis handelt.…”

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