Recent discussions
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Виктория Антонова
If the ET suction is quick and efficient with no loss of HR. Then it should be done. If this cannot be guaranteed, and it most likely cannot, then resuscitation should start immediately. -
Виктория Антонова
The studies reflect our current clinical experience. Since stopping routine suctioning for meconium, we have seen less babies with meconium aspiration and certainly less with PPHN related to meconium and ECMO for meconium aspiration. The disease has certainly not disappeared but far fewer babies are extremely sick. I am glad that the recommendations are not going to change. -
Виктория Антонова
A fair assessment of the available literature. I agree with no changes to the current recommendations. -
Виктория Антонова
Since the NRP statement was publicized I have been concerned about the absolute interpretations of the wording “ROUTINE suctioning is no longer RECOMMENDED” in the depressed infant born through MSAF. In our institution it was taken as an absolute, that no baby should EVER be suctioned below the cords and those of us with many decades of experience who are expert intubators were rebuked harshly for doing so. I am very concerned that the statement has been taken too literally and that it should be reworded in such a way as to give an experienced provider the option without subsequent scorn. -
Виктория Антонова
Since the NRP statement was publicized I have been concerned about the absolute interpretations of the wording “ROUTINE suctioning is no longer RECOMMENDED” in the depressed infant born through MSAF. In our institution it was taken as an absolute, that no baby should EVER be suctioned below the cords and those of us with many decades of experience who are expert intubators were rebuked harshly for doing so. I am very concerned that the statement has been taken too literally and that it should be reworded in such a way as to give an experienced provider the option without subsequent scorn. -
Виктория Антонова
I agree with the findings of the review -
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 . -
Jasmeet Soar
Thank-you for your feedback. I will discuss and consider all your comments with my colleagues on the ILCOR ALS Task Force and post a response in the next few weeks. Regards, Jas. Jasmeet Soar ALS Task Force Chair -
Jasmeet Soar
Thank-you for your feedback. I will discuss and consider all your comments with my colleagues on the ILCOR ALS Task Force and post a response in the next few weeks. Regards, Jas. Jasmeet Soar ALS Task Force Chair -
Виктория Антонова
Good guidelines, except that you recommend supraglottic airway only in low intubation success settings. You suggest that the Wang and also Benger trials have low success rates (51.6% and 69.8%) and the Jabre as high (97.9%). So low success is more-or -less defined here as 50 to 70%? If a service has a success rate in the70’s or 80’s they would not be low by your informal definition. Should these services stick with intubation? I believe not. An intubation success rate in cardiac arrest that is anywhere in the 70’s or 80’s is still poor, and this tells you that these clinicians cannot competently use intubation. Only when success proportions approach mid to high 90’s such as in the Jabre trial can you say competent intubation takes place. I would prefer stronger recommendations here. If clinicians cannot intubate successfully (similar to Benger et al.) then they should be using supraglottic airways.