N-Acetylcysteine (NAC) (Mucomix) — 1 ampoule in 100 mL normal saline — can be effectively used for stomach wash, airway wash, and lung lavage in neonates with thick meconium and risk of aspiration. NAC helps dissolve meconium by breaking down its protein structure, a mechanism valuable in meconium aspiration syndrome and distal intestinal obstruction. It works by cleaving disulfide bonds in mucoproteins, reducing the viscosity of meconium and converting it into a more fluid, gel-like form that can be more easily cleared or passed. Mechanism of Action: Reduces viscosity: The sulfhydryl group in NAC breaks disulfide bonds in mucoproteins, thinning mucus.
Draws in fluid: Its hyperosmolar property attracts fluid into the meconium, further liquefying it. Enhances passage: This makes the meconium more fluid, promoting intestinal clearance. Routes of Administration: Endotracheal: Instilled to…