Recent discussions
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Виктория Антонова
I think that a once suction with laringoscopy before resuscitation provide a better ventilation. -
Виктория Антонова
Eu concordo com as recomendações atuais do Ilcor -
Виктория Антонова
Appreciate the lack of large enough studies to make stronger recommendations. Urgent need for a multicenter RCT to inform "best practices". Until then I suggest (for non-vigorous babies with meconium staining) "One endotracheal suction attempt to clear particulate meconium, then ventilatory support as needed". -
Виктория Антонова
I belive that trachea aspiration of the newborn that is born bathed in meconium liquid and not vigorous, should be performed. After not responding to Positive Preassure Ventilation with mask and there is need to be intubated for better ventilation of the lungs -
Виктория Антонова
Concordo com tudo, não acho necessário nenhuma alteração -
Виктория Антонова
The routine suctioning of non-vigorous infants after meconium aspiration can be perfomed once and both, tracheal suction and intubation must be a priority in these cases . The same like Rita. -
Виктория Антонова
Agree that the wording and recommendations appear to be an accurate reflection of the current state of evidence. Well done. -
Виктория Антонова
The scientific evidence points to the fact that mortality in babies born through meconium stained AF is not related to amount of meconium below the vocal cords but to PPHN from intrauterine hypoxia and vascular remodeling. The morbidity however is related to amount of meconium aspirated and partly can be reduced by prompt suctioning of airway and trachea if possible. But that leads to the delay in initiating the PPV and further delay in return to spontaneous respirations. Since the delay in resuscitation has more harm in causing prolonged hypoxia and brain injury than meconium aspiration pneumonitis, I agree with authors conclusion that in absence of evidence of benefit of routine tracheal suctioning and laryngoscopy, PPV should be offered first after quickly clearing the oropharynx of meconium without visualization. -
Виктория Антонова
I completely agree here. I postulate the vagal effect of suctioning and post delivery direct tracheal intervention only worsens the low heart rate, making it more difficult for the infant to recover. -
Виктория Антонова
There still appears to be quite divergent opinions on tracheal suctioning of the meconium- stained non-vigorous infant due to experience and the relative paucity of newer data. Having been a pediatrician for almost 30 years, I have taken part in many such resuscitations and a small number of babies required tracheal suctioning of meconium to be able to move any air into and out of the lungs. Despite the small number, it truly made a difference in those instances. A statement should be added that when you reach intubation due to lack of response of your initial resuscitation and obstruction is apparent that suctioning should be done prior to providing PPV through the ETT, preferably using a meconium aspirator connection.