• F Michel, C Nicaise, T Camus, J-N Di-Marco, L Thomachot, R Vialet, C Martin, and P Lagier.
• Unité de réanimation pédiatrique et néonatale, unité de brûlés pédiatriques, département d'anesthésie-réanimation, centre hospitalo-universitaire Nord, Assistance publique-Hôpitaux de Marseille, faculté de médecine de Marseille, université de la Méditerranée, chemin des Bourrelys, 13915 Marseille cedex 20, France. fabrice.michel@ap-hm.fr
• Ann Fr Anesth Reanim. 2010 Sep 1; 29 (9): 605-9.

ObjectiveRegional guideline for immediate tracheal suctioning (ITS) in vigorous and non-vigorous infants born through meconium-stained amniotic fluid (MSAF) has been established in 2003. The objective of this study was to evaluate guideline application.Study DesignProspective cohort.Patients And MethodsThe first part of the study was a short survey about ITS practices in maternity hospitals then, management and early evolution of babies born through particulate MSAF was evaluated by questionnaire.ResultsAmong 6761 neonates, 199 (3%) were born with MSAF. Early clinical evaluation showed 52 (26%) non-vigorous neonates; 22 of them (42%) have had an ITS. One hundred and forty-seven neonates were vigorous (74%); 27 of them (18%) have had an ITS. Implementation of recommendations in non-vigorous babies was better in maternities of level III, while they were lower in maternities of level IIA for vigorous babies. Among 52 non-vigorous children, eight had a meconium aspiration syndrome (MAS), including five who had an ITS. One MAS occurred in vigorous babies but infection could not be excluded.ConclusionRecommendations for ITS were implemented in 70% of cases but only in 42% of cases in non-vigorous babies. We have to improve formation and circulation of new recommendations.Copyright (c) 2010 Elsevier Masson SAS. All rights reserved.

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