Recent discussions
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Виктория Антонова
Agree with current recommendations. We have not seen any increased incidence of MAS or PPHN with these recommendations -
Виктория Антонова
I agree with the comments that have the sentiments seen in the above comments of Jonathan Wyllie, Ahmed Moussa and Leeanne Lauzon. The evidence doesn't support or refute this historical practice of intubation/suction with perfect clarity. Given this is the difficult reality, the task force did a solid job and provided a recommendation that supports no routine suctioning but allows for individual use of suctioning on a case-by-case basis. -
Виктория Антонова
Good Work: The limited evidence available still doesn't support laryngoscopy and routine tracheal suctioning for non vigorous infants with mec stained fluid. But there are still unanswered questions regarding suctioning: should non vigorous infants born through meconium be suctioned (mouth and nose-blind) at the moment of birth, or after being brought to warmer or after attempting PPV as part of MRSOPA? Or should oral suction be limited to what ever is required to visualise the cords during intubation? -
Виктория Антонова
Agree with the authors' recommendations based on the evidence available thus far. Appreciate the clarification offered by Jonathan Wyllie: "recommendations and guidelines do not preclude experts making treatment decisions appropriate to individual cases as long as they can be justified". -
Виктория Антонова
I believe that even thought the evidence is not what we would like for these types of recommendations in neonatal resuscitation, and working with newborns in a middle income country (Colombia) as a neonatologist for the past 25 years were we do have a high amount of meconium stained liquid, the recommendation of not aspirating and starting positive pressure ventilation has been easier for us in clinical practice and in training, and we have better outcomes in our babies. -
Виктория Антонова
concordo que a ventilação inicial antes da aspiração direta da traqueia ,para aqueles que não têm boa prática de intubação, num bebê instável deve ser sempre considerada, porém nos bebês ativos,deve-se aspirar apenas o orofaringe. aguardamos novas recomendações. -
Виктория Антонова
Agree with the author's recommendations. Now it's up to NRP and other educational programs to figure out how to incorporate these recommendations in the resuscitation algorithm. Since we move away from routine intubation and suctioning, some practitioners wonder if the practice of routine oropharyngeal suctioning either at perineum or soon after delivery should be reevaluated. Although some studies showed no benefit in then past, they were conducted in an era where routine intubation and tracheal suctioning were routine. Thanks! -
Виктория Антонова
I think that just a one suction with laringoscopy before resuscitation provide a better ventilation with less obstruction of airways -
Виктория Антонова
Agree with the wording in this document. Appreciate that the team has well revised the available data. This is not a simple issue, but erring on the safe side as this is worded is good for me. Thank you! -
Виктория Антонова
A aspiração traqueal não é um procedimento rápido em mãos pouco experientes. E isso pode retardar a ventilação e reanimação, além de traumática. O mecônio pode ser aspirado apenas em Via Aéreas Superiores, como outras secreções, de acordo com os passos iniciais, facilitando e auxiliando o início da ventilação. Em casos específicos, com secreção muito espessa que esteja atrapalhando a ventilação, ai sim, aspiração traqueal. Acredito que as recomendações atuais ainda são pertinentes.