Subscribe to RSS
DOI: 10.1055/s-0038-1677477
The “Meconium Aspirator”: Still a Useful Tool during Newborn Resuscitation
Funding None.Publication History
12 November 2018
02 December 2018
Publication Date:
15 January 2019 (online)
![](https://www.thieme-connect.de/media/ajp/201913/lookinside/thumbnails/10-1055-s-0038-1677477_180519-1.jpg)
The neonatal tracheal aspiration device, commonly called the “meconium aspirator,” has traditionally been used to remove meconium from the trachea of infants born through meconium-stained amniotic fluid (MSAF). However, it can also be used to clear other material such as amniotic fluid, vernix, blood, and cellular debris.[1] In 2015, the practice of resuscitating infants born through MSAF was changed. No longer is intubation and tracheal aspiration indicated for nonvigorous newborns. Instead, the resuscitation of newborns with MSAF now follows the same principles as the resuscitation of newborns with clear amniotic fluid. This has led some to believe that the meconium aspirator no longer has a role during neonatal resuscitation. However, despite the 2015 changes in neonatal resuscitation guidelines, the meconium aspirator remains an important piece of equipment for newborn resuscitation. In this perspective, we review the history of tracheal aspiration of the newborn, describe the devices used for tracheal aspiration, and examine the current indications for tracheal aspiration, highlighting the continued status of the “meconium” aspirator as a useful tool during newborn resuscitation.
Authors' Contributions
Dr. Chabra, Dr. Sawyer, and Dr. Strand conceptualized and designed this article, drafted the initial article, and reviewed and revised the article. All authors approved the final article as submitted and agree to be accountable for all aspects of the work.
-
References
- 1 Weiner GM. , ed. Textbook of Neonatal Resuscitation, 7th ed. Chicago, IL: American Academy of Pediatrics; 2015
- 2 Clifford Sh. Fetal anoxia at birth and cyanosis of the newborn: differential diagnosis and management. Am J Dis Child 1948; 76 (06) 666-678
- 3 Taylor WC, James JA, Henderson JL. The significance of yellow vernix in the newborn. Arch Dis Child 1952; 27 (135) 442-444
- 4 James L. Resuscitation procedures in the delivery room. In: Harold A. , ed. Resuscitation of the Newborn Infant. St. Louis: CV Mosby Co; 1960: 141
- 5 Gregory GA, Gooding CA, Phibbs RH, Tooley WH. Meconium aspiration in infants--a prospective study. J Pediatr 1974; 85 (06) 848-852
- 6 Aguilar AM, Vain NE. The suctioning in the delivery room debate. Early Hum Dev 2011; 87 (Suppl. 01) S13-S15
- 7 Rawat M, Nangia S, Chandrasekharan P, Lakshminrusimha S. Approach to infants born through meconium-stained amniotic fluid: evolution based on evidence?. Am J Perinatol 2018; 35 (09) 815-822
- 8 Wiswell TE, Gannon CM, Jacob J. , et al. Delivery room management of the apparently vigorous meconium-stained neonate: results of the multicenter, international collaborative trial. Pediatrics 2000; 105 (1 Pt 1): 1-7
- 9 Kattwinkel J, Niermeyer S, Nadkarni V. , et al. Resuscitation of the newly born infant: an advisory statement from the Pediatric Working Group of the International Liaison Committee on Resuscitation. Resuscitation 1999; 40 (02) 71-88
- 10 Kattwinkel J. Textbook of Neonatal Resuscitation, 4th ed. Chicago, IL: American Academy of Pediatrics; 2000
- 11 Perlman JM, Wyllie J, Kattwinkel J. , et al; Neonatal Resuscitation Chapter Collaborators. Part 7: neonatal resuscitation: 2015 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation 2015; 132 (16) (Suppl. 01) S204-S241
- 12 Committee opinion no.689 summary: delivery of a newborn with meconium-stained amniotic fluid. Obstet Gynecol 2017; 129 (03) 593-594
- 13 Wiswell TE. Appropriate management of the nonvigorous meconium-stained neonate: an unanswered question. Pediatrics 2018; 142 (06) e20183052
- 14 Russian CJ, Gonzales JF, Henry NR. Suction catheter size: an assessment and comparison of 3 different calculation methods. Respir Care 2014; 59 (01) 32-38
- 15 Samson R, Schexnayder S, Hazinski MF. , et al. Pediatric Advanced Life Support (PALS) Provider Manual. Chicago, IL: American Academy of Pediatrics and American Heart Association; 2016