Document Detail


Tracheal Suctioning Improves Gas Exchange but not Hemodynamics in Asphyxiated Lambs with Meconium Aspiration.
MedLine Citation:
PMID:  25406897     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BackgroundCurrent neonatal resuscitation guidelines recommend tracheal suctioning of non-vigorous neonates born through meconium stained amniotic fluid.MethodsWe evaluated the effect of tracheal suctioning at birth in 29 lambs with asphyxia induced by cord occlusion and meconium aspiration during gasping.ResultsTracheal suctioning at birth (n=15) decreased amount of meconium in distal airways (53±29 particles/mm(2) lung area) compared to no-suction (499±109 particles/mm(2), n=14, p<0.001). Three lambs in the suction group had cardiac arrest during suctioning requiring chest compressions and epinephrine. Onset of ventilation was delayed in the suction group (146±11 vs. 47±3 sec in no-suction group, p=0.005). There was no difference in pulmonary blood flow, carotid blood flow, pulmonary or systemic blood pressure between the two groups. Left atrial pressure was significantly higher in the suction group. Tracheal suctioning resulted in higher PaO2/FiO2 levels (122±21 vs. 78±10 mmHg) and ventilator efficiency index (0.3±0.05 vs.0.16±0.03). Two lambs in the no-suction group required inhaled NO. Lung 3-nitrotyrosine levels were higher in the suction group (0.65±0.03 ng/µg protein) compared to the no-suction group (0.47 ± 0.06).ConclusionTracheal suctioning improves oxygenation and ventilation. Suctioning does not improve pulmonary/systemic hemodynamics or oxidative stress in an ovine model of acute meconium aspiration with asphyxia.Pediatric Research (2014); doi:10.1038/pr.2014.186.
Authors:
Satyan Lakshminrusimha; Bobby Mathew; Jayasree Nair; Sylvia F Gugino; Carmon Koenigsknecht; Munmun Rawat; Lori Nielsen; Daniel D Swartz
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Publication Detail:
Type:  REVIEW     Date:  2014-11-19
Journal Detail:
Title:  Pediatric research     Volume:  -     ISSN:  1530-0447     ISO Abbreviation:  Pediatr. Res.     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-11-19     Completed Date:  -     Revised Date:  2014-11-20    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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