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Non-vigorous newborn infants and role of tracheal suctioning

Journal of Perinatology volume 43, page 128 (2023)Cite this article

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I read with interest the article by Kalra et al. [1] describing a higher incidence of NICU admission for meconium aspiration syndrome (MAS) and respiratory distress (RD) among non-vigorous infants born through meconium-stained amniotic fluid without routine-tracheal suctioning as compared to the routine-suction era, 53.3 versus 15.4% (MAS) and 60% versus 17.9% (RD), respectively. Although the rate of admission among infants with RD and MAS was high in the no-suction era, the severity index (days on invasive ventilation and duration of hospital stay) was relatively lower as compared to the routine suction era.

The mean duration of respiratory support in the no-suction era was 1.81 days as compared to 2.33 days in the routine suction era. Similarly, the mean duration of invasive mechanical ventilation was 2 days versus 3.67 days in the no-suction and routine suction era, respectively. Hospital stay is used as a surrogate of a quality index. We note that the mean duration of hospital stay was longer in the routine suction era, 9 days versus 6.24 days in the no-suction era. These data suggest that although the rate of admission with RD and MAS has increased in the no-suction era, the other quality metrics have improved (fewer ventilation days, short length of hospital stay).

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Reference

  1. Kalra V, Leegwater AJ, Vadlaputi P, Garlapati P, Chawla S, Lakshminrusimha S. Neonatal outcomes of non-vigorous neonates with meconium-stained amniotic fluid before and after change in tracheal suctioning recommendation. J Perinatol. 2022;42:769–74. https://doi.org/10.1038/s41372-021-01287-0.

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  1. Section of Neonatology, Department of Pediatrics, College of Medicine, Louisiana State University of Health Sciences, Shreveport, LA, USA

    Shabih Manzar

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  1. Shabih Manzar
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SM conceptualized and wrote the manuscript.

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Correspondence to Shabih Manzar.

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Manzar, S. Non-vigorous newborn infants and role of tracheal suctioning. J Perinatol 43, 128 (2023). https://doi.org/10.1038/s41372-022-01473-8

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