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Berisha G, Kvenshagen LN, Boldingh AM, Nakstad B, Blakstad E, Rønnestad AE, Solevåg AL. Video-Recorded Airway Suctioning of Clear and Meconium-Stained Amniotic Fluid and Associated Short-Term Outcomes in Moderately and Severely Depressed Preterm and Term Infants. CHILDREN (BASEL, SWITZERLAND) 2023; 11:16. [PMID: 38255330 PMCID: PMC10814005 DOI: 10.3390/children11010016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/11/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND The aim of this study was to investigate delivery room airway suctioning and associated short-term outcomes in depressed infants. METHODS This is a single-centre prospective observational study of transcribed video recordings of preterm (gestational age, GA < 37 weeks) and term (GA ≥ 37 weeks) infants with a 5 min Apgar score ≤ 7. We analysed the association between airway suctioning, breathing, bradycardia and prolonged resuscitation (≥10 min). For comparison, non-suctioned infants with a 5 min Apgar score ≤ 7 were included. RESULTS Two hundred suction episodes were performed in 19 premature and 56 term infants. Breathing improved in 1.9% of premature and 72.1% of term infants, and remained unchanged in 84.9% of premature and 27.9% of term infants after suctioning. In our study, 61 (81.3%) preterm and term infants who were admitted to the neonatal intensive care unit experienced bradycardia after airway suctioning. However, the majority of the preterm and more than half of the term infants were bradycardic before the suction procedure was attempted. Among the non-airway suctioned infants (n = 26), 73.1% experienced bradycardia, with 17 non-airway suctioned infants being admitted to the neonatal intensive care unit. There was a need for resuscitation ≥ 10 min in 8 (42.1%) preterm and 32 (57.1%) term infants who underwent airway suctioning, compared to 2 (33.3%) preterm and 19 (95.0%) term infants who did not receive airway suctioning. CONCLUSIONS In the infants that underwent suctioning, breathing improved in most term, but not preterm infants. More non-suctioned term infants needed prolonged resuscitation. Airway suctioning was not directly associated with worsening of breathing, bradycardia, or extended resuscitation needs.
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Affiliation(s)
- Gazmend Berisha
- The Department of Paediatric and Adolescent Medicine, Akershus University Hospital, P.O. Box 1000, 1478 Lørenskog, Norway; (A.M.B.); (E.B.)
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, P.O. Box 1171, 0318 Oslo, Norway; (L.N.K.); (B.N.); (A.E.R.)
- The Department of Anaesthesia and Intensive Care Unit, Stavanger University Hospital, P.O. Box 8100, 4068 Stavanger, Norway
| | - Line Norman Kvenshagen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, P.O. Box 1171, 0318 Oslo, Norway; (L.N.K.); (B.N.); (A.E.R.)
- Department of Paediatrics and Adolescent Medicine, Østfold Hospital Trust Kalnes, P.O. Box 300, 1714 Grålum, Norway
| | - Anne Marthe Boldingh
- The Department of Paediatric and Adolescent Medicine, Akershus University Hospital, P.O. Box 1000, 1478 Lørenskog, Norway; (A.M.B.); (E.B.)
| | - Britt Nakstad
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, P.O. Box 1171, 0318 Oslo, Norway; (L.N.K.); (B.N.); (A.E.R.)
- Department of Paediatrics and Adolescent Health, University of Botswana, Private Bag, Gaborone 0022, Botswana
| | - Elin Blakstad
- The Department of Paediatric and Adolescent Medicine, Akershus University Hospital, P.O. Box 1000, 1478 Lørenskog, Norway; (A.M.B.); (E.B.)
| | - Arild Erland Rønnestad
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, P.O. Box 1171, 0318 Oslo, Norway; (L.N.K.); (B.N.); (A.E.R.)
- Department of Neonatal Intensive Care, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Rikshospitalet, Nydalen, P.O. Box 4950, 0424 Oslo, Norway;
| | - Anne Lee Solevåg
- Department of Neonatal Intensive Care, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Rikshospitalet, Nydalen, P.O. Box 4950, 0424 Oslo, Norway;
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