Removing Meconium From Infant Tracheae What Works Best?

Have the Year 2000 Neonatal Resuscitation Program Guidelines Changed the Delivery Room Management or Outcome of Meconium-Stained Infants?

“…However, as a few investigators noted, INT and intratracheal suctioning was not completely beneficial and had potential complications such as bradycardia, hypoxemia, reduced 1-minute APGAR score, perforation of larynx or pharynx, dislocation of vocal cords, hoarseness or stridor and apnea. 11 The controversy surrounding the best approach for the vigorous infant with meconium staining was recently addressed by a randomized prospective study by Wiswell et al 1 Based on the results of this multicenter study showing no benefit to routine tracheal suctioning in this group of newborns, a selective approach was recommended by the NRP in the most recent 2000 guidelines. This study lends further support to these guidelines.…”

Delivery room management of the meconium-stained newborn

“…Many devices (at least 20) were commercially developed as alternatives to the straw method. Bent (Figure 8) et al 10 assessed the various methods and found one to be consistently the best.…”

Tracheal suctioning improves gas exchange but not hemodynamics in asphyxiated lambs with meconium aspiration

“…In the current study, tracheal suctioning resulted in recovery of approximately 60% of instilled meconium. Using an in vitro model of piglet respiratory system, Bent et al recovered 85-89% of meconium with 80-150 mmHg suction( 26 ). In adult rabbits with meconium aspiration, suctioning with a meconium aspirator after 10 min of ventilation recovered 14.8 ± 5.5% of meconium; suction with a 8-F catheter recovered 19.5 ± 5% of instilled meconium( 27 ).…”