Editing Meconium aspiration syndrome (section)

=== Assisted ventilation techniques ===
To clear the airways of meconium, [[trachea]]l suctioning can be used however, the efficacy of this method is in question and it can cause harm.<ref name=":9">{{Cite journal|last1=Aguilar|first1=AM|last2=Vain|first2=NE|date=2011|title=The Suctioning in the Delivery Room Debate|journal=Early Human Development|volume=87S|pages=S13–S15|doi=10.1016/j.earlhumdev.2011.01.003|pmid=21277716 }}</ref>

In cases of MAS, there is a need for supplemental oxygen for at least 12 hours in order to maintain oxygen saturation of haemoglobin at 92% or more. The severity of respiratory distress can vary significantly between newborns with MAS, as some require minimal or no supplemental oxygen requirement and, in severe cases, mechanical ventilation may be needed.<ref>{{Cite journal|last1=Vain|first1=NE|last2=Szyld|first2=EG|last3=Prudent|first3=LM|last4=Wiswell|first4=TE|last5=Aguilar|first5=AM|last6=Vivas|first6=NI|date=2004|title=Oropharyngeal and Nasopharyngeal Suctioning of Meconium-Stained Neonates Before Delivery of their Shoulders: Multicentre, Randomised Controlled Trial|journal=Lancet|volume=364|issue=9434 |pages=597–602|doi=10.1016/S0140-6736(04)16852-9|pmid=15313360 |s2cid=29268118 }}</ref><ref name=":1" /> The desired oxygen saturation is between 90 and 95% and [[PaO2|PaO<sub>2</sub>]] may be as high as 90mmHg.<ref name=":10">{{Cite journal|last1=Chettri|first1=S|last2=Bhat|first2=BV|last3=Adhisivam|first3=B|date=2016|title=Current Concepts in the Management of Meconium Aspiration Syndrome|journal=Indian J Paediatr|volume=83|issue=10|pages=1125–1130|doi=10.1007/s12098-016-2128-9|pmid=27206687|s2cid=4723566}}</ref> In cases where there is thick meconium deep within the lungs, [[mechanical ventilation]] may be required. In extreme cases, [[extracorporeal membrane oxygenation]] (ECMO) may be utilised in infants who fail to respond to ventilation therapy.<ref name=":1" /> While on ECMO, the body can have time to absorb the meconium and for all the associated disorders to resolve. There has been an excellent response to this treatment, as the survival rate of MAS while on ECMO is more than 94%.<ref>{{Cite journal|last=Short|first=BL|date=2008|title=Extracorporeal Membrane Oxygenation: Use in Meconium Aspiration Syndrome|journal=Journal of Perinatology|volume=28|pages=S79–S83|doi=10.1038/jp.2008.152|pmid=19057615|doi-access=free}}</ref>

Ventilation of infants with MAS can be challenging and, as MAS can affect each individual differently, ventilation administration may need to be customised. Some newborns with MAS can have homogenous lung changes and others can have inconsistent and patchy changes to their lungs. It is common for sedation and muscle relaxants to be used to optimise ventilation and minimise the risk of [[pneumothorax]] associated with dyssynchronous breathing.<ref name=":8" />