Endotracheal Suction for Nonvigorous Neonates Born through Meconium Stained Amniotic Fluid: A Randomized Controlled Trial

Subhash Chettri, Bethou Adhisivam, B Vishnu Bhat
Journal of Pediatrics 2015, 166 (5): 1208-1213.e1

OBJECTIVE: To assess whether endotracheal suctioning of nonvigorous infants born through meconium stained amniotic fluid (MSAF) reduces the risk and complications of meconium aspiration syndrome (MAS).

STUDY DESIGN: Term, nonvigorous babies born through MSAF were randomized to endotracheal suction and no-suction groups (n=61 in each). Risk of MAS, complications of MAS and endotracheal suction, mortality, duration of neonatal intensive care unit stay, and neurodevelopmental outcome at 9 months were assessed.

RESULTS: Maternal age, consistency of meconium, mode of delivery, birth weight, sex, and Apgar scores were similar in the groups. In total, 39 (32%) neonates developed MAS and 18 (14.8%) of them died. There were no significant differences in MAS, its severity and complications, mortality, and neurodevelopmental outcome for the 2 groups. One infant had a complication of endotracheal suctioning, which was mild and transient.

CONCLUSIONS: The current practice of routine endotracheal suctioning for nonvigorous neonates born through MSAF should be further evaluated.

TRIAL REGISTRATION: Clinical Trial Registry of India: CTRI/2013/03/003469.

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