Endotreacheal suction immediately after birth for preventing meconium aspiration syndrome

Abstract

Objective To determine if endotracheal intubation and suction of the airways of meconium-stained babies at birth is more beneficial in preventing meconium aspiration syndrome (MAS)than endotracheal intubation and lavage,and to study the relationship of the incidence of meconium aspiration with vigorous of infants at birth. Methods Four hundred and ninety-five infants born through thick meconium-stained amniotic fluid were randomized to either suction group or lavage group from Jan.2004 to Dec.2006.Infants were routinely endotreacheal intubated at birth, 249 infants of the suction group were aspirated after flapping back and postural drainage and 246 infants of the lavage group were treated with tracheobronc hial lavage with saline.The morbidities,complication and prognosis of MAS were compared between the two groups. Results The incidence of MAS was 7.6%and 11.4%in the suction group and the lavage group respectively(x2=2.45,P＞0.05).But the incidence of severe MAS was significant lower in the suction group(0.8%,2/249)than in the lavage group(4.5%,11/246)(x2=6.51,P＜0.05).The rate of mechanical ventilation was similar between the two groups(0.4%vs 2.8%,y2=3.12,P＞0.05).No infants died in the the suction group,but 3 infants died in the lavage group(fatality rate 1.2%).The mean meconiumstained fluid aspirated was about 0.86 ml and 1.65 ml respectively for infants of Apgar scoring 9～1 0and≤8 in the suction group and there was statistical significant difference between the two groups(Z=1.44,P＜0.05).Thirty-eight of 214 infants(17.8%)with vigorous in the suction group had meconium-stained fluid aspirated and 10 in 38 infants(26.3%)had a great volume of fluid aspirated from their airway. Conclusions Endotracheal intubation and suction of the airways at birth in meconium-stained babies cannot reduce the morbidity of MAS.but it can prevent the complication and reduce the mortality of MAS.The viable newborns should also be treated actively for potential MAS. Key words: Infant,newborn; Meconium aspiration syndrome; Intubation,intratracheal; Suction; Treatment outcome