Tracheal suctioning improves gas exchange but not hemodynamics in asphyxiated lambs with meconium aspiration

摘要: Current neonatal resuscitation guidelines recommend tracheal suctioning of nonvigorous neonates born through meconium-stained amniotic fluid. We evaluated the effect at birth in 29 lambs with asphyxia induced by cord occlusion and meconium aspiration during gasping. Tracheal (n = 15) decreased amount distal airways (53 ± 29 particles/mm2 lung area) compared to no suction (499 ± 109 particles/mm2; n 14; P < 0.001). Three group had cardiac arrest suctioning, requiring chest compressions epinephrine. Onset ventilation was delayed (146 ± 11 vs. 47 ± 3 s no-suction group; 0.005). There difference pulmonary blood flow, carotid or systemic pressure between two groups. Left atrial significantly higher group. resulted Pao2/FiO2 levels (122 ± 21 78 ± 10 mm Hg) ventilator efficiency index (0.3 ± 0.05 vs.0.16 ± 0.03). Two required inhaled nitric oxide. Lung 3-nitrotyrosine were (0.65 ± 0.03 ng/µg protein) (0.47 ± 0.06). improves oxygenation ventilation. Suctioning does not improve pulmonary/systemic hemodynamics oxidative stress an ovine model acute asphyxia.