Pediatrics
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Comparative Study
Intratracheal suctioning, systemic infection, and the meconium aspiration syndrome.
A retrospective analysis was performed to determine: (1) the proportion of neonates with the meconium aspiration syndrome (MAS) who were not depressed at birth; (2) to evaluate the clinical course of neonates with MAS, particularly relating to whether or not delivery room intubation and intratracheal suctioning had taken place; and (3) to examine the incidence of culture-proven bacteremia among meconium-stained neonates and those with MAS. The medical records of all meconium-stained neonates and those with MAS admitted to our facility from 1985 through 1989 were reviewed. Of 5697 liveborn neonates, 741 (13%) were meconium-stained, of whom 608 (82%) were intubated and suctioned in the delivery room. ⋯ Nine (75%) of 12 nonsuctioned neonates, as well as 6 (25%) of 24 suctioned neonates, required mechanical ventilation for more than 6 hours (P = .010). Pneumothoraces occurred in 6 (50%) of 12 nonsuctioned and 5 (21%) of 24 suctioned babies (P = .125). Four of 12 nonsuctioned newborns either died (n = 1) or required extracorporeal membrane oxygenation (n = 3), while only 1 of the suctioned newborns required extracorporeal membrane oxygenation (P = .034).(ABSTRACT TRUNCATED AT 250 WORDS)