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Endotracheal Suction for Nonvigorous Neonates Born through Meconium Stained Amniotic Fluid: A Randomized Controlled
Subhash Chettri1, Bethou Adhisivam1, B Vishnu Bhat1
1Neonatology Division, Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.
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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