Surfactant for meconium aspiration syndrome in full term infants

2000 ◽  
Author(s):  
RF Soll ◽  
P Dargaville
Keyword(s):  
Meconium Aspiration Syndrome ◽  
Full Term ◽  
Term Infants ◽  
Meconium Aspiration

Surfactant Therapy in Full-term Neonates With Severe Respiratory Failure

PEDIATRICS ◽  
1993 ◽  
Vol 92 (1) ◽  
pp. 135-139
Author(s):  
Hatem Khammash ◽  
Max Perlman ◽  
Julian Wojtulewicz ◽  
Michael Dunn
Keyword(s):  
Respiratory Failure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Oxygenation Index ◽  
Meconium Aspiration Syndrome ◽  
Full Term ◽  
Surfactant Therapy ◽  
Term Infants ◽  
Meconium Aspiration

Objective. In light of the paucity of published data on the use of surfactant in full-term infants with respiratory failure due to meconium aspiration syndrome and respiratory distress syndrome, we report our experience with this therapy. Our goal was to explore possible justification for randomized controlled trials of surfactant treatment in similar patients at an earlier, less severe stage of the disease. Methods. Retrospective consecutive case series of 20 infants with severe meconium aspiration syndrome and 29 infants with severe respiratory distress syndrome who received bovine surfactant between March 1990 and December 1992 in three neonatal intensive care units in a regionalized setting. Outcome of treatment was assessed by comparing changes in several respiratory indices including the oxygenation index, between 4 and 6 hours and 1 and 3 hours before and after the first dose of surfactant. Differences were analyzed using analysis of variance for repeated measures, with treatment and time as co-variates. Results. In the meconium aspiration group the mean oxygenation index decreased from 36 ± 12 at 1 to 3 hours presurfactant to 24 ± 14 at 1 to 3 hours postsurfactant (P < .001). In the patients with respiratory distress syndrome the mean oxygenation index fell from 30 ± 17 at 1 to 3 hours presurfactant to 12 ± 6 at 1 to 3 hours postsurfactant (P = .0001). Three of 20 patients with meconium aspiration syndrome and 3 of 29 patients with respiratory distress syndrome received extracorporeal membrane oxygenation. Conclusions. Surfactant therapy in full-term infants with respiratory failure due to the meconium aspiration and respiratory distress syndromes is often effective in improving gas exchange. A randomized controlled trial of surfactant therapy at an earlier stage in the course of the illness should be performed.

Steroids in full term infants with respiratory failure and pulmonary hypertension due to meconium aspiration syndrome

2001 ◽  
Vol 160 (3) ◽  
pp. 150-153 ◽  
Author(s):  
David Eustace da Costa ◽  
Arun Kumar Nair ◽  
Mangalore Govind Pai ◽  
Saleh Mohammed Al Khusaiby
Keyword(s):  
Pulmonary Hypertension ◽  
Respiratory Failure ◽  
Meconium Aspiration Syndrome ◽  
Full Term ◽  
Term Infants ◽  
Meconium Aspiration

Wilson-Mikity or Meconium Aspiration Syndrome?

PEDIATRICS ◽  
1973 ◽  
Vol 51 (2) ◽  
pp. 311-311
Author(s):  
Morton L. Cohen
Keyword(s):  
Respiratory Distress ◽  
Meconium Aspiration Syndrome ◽  
Full Term ◽  
Term Neonate ◽  
Meconium Aspiration ◽  
Chest Film ◽  
Classic Case ◽  
The Third

In reporting the third case of Wilson-Mikity syndrome in a full-term neonate, Drs. Keidel and Feingold1 appear instead to have described a classic case of meconium aspiration syndrome. Their patient, delivered with difficulty at 41 weeks' gestation, aspirated meconium at the time of delivery and was severely asphyxiated at birth. Respiratory distress developed after resuscitation and the baby was noted to have "diffuse granularity of both lung fields and hyperinflation indicating meconium aspiration." Later, when the chest film showed "hyperexpanded lungs with depressed diaphragms and cyst-like foci alternating with coarse infiltrates" their diagnostic impression apparently changed to Mikity-Wilson syndrome.

scholarly journals Advances in the Management of Meconium Aspiration Syndrome

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Kamala Swarnam ◽  
Amuchou S. Soraisham ◽  
Sindhu Sivanandan
Keyword(s):  
Nitric Oxide ◽  
Meconium Aspiration Syndrome ◽  
Term Infants ◽  
Severe Respiratory Distress ◽  
Meconium Aspiration ◽  
Common Cause ◽  
Acute Airway Obstruction ◽  
Life Threatening ◽  
Surfactant Dysfunction ◽  
Over Time

Meconium aspiration syndrome (MAS) is a common cause of severe respiratory distress in term infants, with an associated highly variable morbidity and mortality. MAS results from aspiration of meconium during intrauterine gasping or during the first few breaths. The pathophysiology of MAS is multifactorial and includes acute airway obstruction, surfactant dysfunction or inactivation, chemical pneumonitis with release of vasoconstrictive and inflammatory mediators, and persistent pulmonary hypertension of newborn (PPHN). This disorder can be life threatening, often complicated by respiratory failure, pulmonary air leaks, and PPHN. Approaches to the prevention of MAS have changed over time with collaboration between obstetricians and pediatricians forming the foundations for care. The use of surfactant and inhaled nitric oxide (iNO) has led to the decreased mortality and the need for extracorporeal membrane oxygenation (ECMO) use. In this paper, we review the current understanding of the pathophysiology and management of MAS.

Surfactant Replacement Therapy for Meconium Aspiration Syndrome

PEDIATRICS ◽  
1996 ◽  
Vol 97 (1) ◽  
pp. 48-52 ◽  
Author(s):  
Richard D. Findlay ◽  
H. William Taeusch ◽  
Frans J. Walther
Keyword(s):  
Mechanical Ventilation ◽  
Replacement Therapy ◽  
Meconium Aspiration Syndrome ◽  
Control Group ◽  
Study Group ◽  
Term Infants ◽  
Meconium Aspiration ◽  
Air Leaks ◽  
Surfactant Replacement Therapy ◽  
Pulmonary Morbidity

Objective. The pathophysiology of meconium aspiration syndrome (MAS) is related not only to mechanical obstruction of the airways and chemical injury to the respiratory epithelium but also to surfactant inactivation by meconium. A randomized, controlled study was performed to determine whether high-dose surfactant therapy improves the pulmonary morbidity of term infants ventilated for MAS. Methods. Forty term infants receiving mechanical ventilation for MAS were enrolled in this trial, in which the infants in the study group (n = 20) received up to four doses of 150 mg (6 mL)/kg beractant (Survanta), instilled every 6 hours by continuous infusion for 20 minutes via a side hole endotracheal tube adapter, and the infants in the control group (n = 20) received 6 mL/kg air placebo. Results. Mean arterial-to-alveolar Po2 ratio values increased from 0.09 to 0.11 at 1 and 6 hours with a concomitant slight decrease in oxygenation index values from 23.7 to 19.7 at 1 hour and 20.7 at 6 hours after the first dose of surfactant. Oxygenation improved cumulatively after the second and third dose of surfactant, with mean arterial-to-alveolar Po2 ratios and oxygenation indices of 0.18 and 12.1 at 6 hours after the second dose of surfactant and 0.31 and 5.9 at 6 hours after the third dose of surfactant, eliminating the need for a fourth dose in any infant in the study group. After three doses of surfactant, persistent pulmonary hypertension had resolved in all but one of the infants in the study group versus none of the infants in the control group. No air leaks developed in any of the 20 infants in the study group after surfactant therapy, and only 1 infant required extracorporeal membrane oxygenation. Air leaks developed in 5 of the 20 infants in the control group, and 6 underwent extracorporeal poreal membrane oxygenation. The duration of mechanical ventilation, oxygen therapy, and admission was significantly shorter in the surfactant group than in the control group. Conclusion. Surfactant replacement therapy, if started within 6 hours after birth, improves oxygenation and reduces the incidence of air leaks, severity of pulmonary morbidity, and hospitalization time of term infants with MAS.

scholarly journals Profil Sindrom Aspirasi Mekonium pada Bayi Baru Lahir di RSUD Dr. Soetrasno Rembang

2019 ◽  
Vol 1 (2) ◽  
pp. 42
Author(s):  
Ahimsa Yoga Anindita ◽  
Dwi Hidayah ◽  
Yulidar Hafidh ◽  
Annang Giri Moelyo ◽  
Mayasari Dewi
Keyword(s):  
Birth Weight ◽  
Amniotic Fluid ◽  
Gestational Age ◽  
Apgar Score ◽  
Meconium Aspiration Syndrome ◽  
Normal Birth Weight ◽  
Term Infants ◽  
Meconium Aspiration ◽  
Normal Birth ◽  
Minute Apgar Score

<p class="TextAbstract"><strong>Introduction</strong>: The presence of meconium in amniotic fluid occurs in 13% of live births in developing countries. This condition develops when the gestational age increases at delivery. Meconium aspiration syndrome occurs in 5% of newborns in meconium stained amniotic fluid. The aim of this study is to determine the profile of newborns who experience meconium aspiration syndrome (MAS) who are treated at Dr. Soetrasno Hospital, Rembang and its outcome.</p><p class="TextAbstract"><strong>Methods</strong>: Prospective study, data were obtained from medical records of Dr. Soetrasno Hospital, Rembang during September to October 2018, on newborns with MAS.</p><p class="TextAbstract"><strong>Results</strong>: Of 12 newborns with MAS were obtained, consisting of 7 (58.3%) male and 5 (41.7%) female. All cases were term infants (gestational age above 37 weeks) and normal birth weight (above 2500 grams). Based on the first minute APGAR score, there were 4 newborns had score 1 and 2, respectively (33.3%). Based on the fifth minute APGAR score, there were 7 newborns had score 3 (58.3%). The outcome of newborns with MAS were 7 alive (58.3%) and 5 died (41.7%).</p><p class="TextAbstract"><strong>Conclusion</strong>: There were 12 newborns suffering from MAS (54.5%) of 22 babies hospitalized at the NICU dr. Soetrasno Hospital Rembang. All newborns with MAS were term infants and normal birth weight. There were 5 newborns with MAS which required invasive mechanical ventilation (intubation) and all died (41.7%).</p><p class="Keywords"> </p>

scholarly journals TO STUDY THE CLINICAL PROFILE OF MECONIUM ASPIRATION SYNDROME (MAS) IN NEONATES IN RELATION TO BIRTH WEIGHT, GESTATIONALAGE AND THEIR IMMEDIATE OUTCOME

2021 ◽  
pp. 1-4
Author(s):  
Mithilesh Kumar ◽  
R. K. Sinha ◽  
Debarshi Jana
Keyword(s):  
Birth Weight ◽  
Respiratory Distress ◽  
Gestational Age ◽  
Apgar Score ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Clinical Profile ◽  
Term Infants ◽  
Cross Sectional ◽  
Meconium Aspiration

Study the clinical profile of meconium aspiration syndrome (MAS) in neonates, in relation to birth weight, gestational age and their immediate outcome. Prospective observational cross sectional study. All preterm, term and post term infants, appropriate for gestational age with birth weight, delivered normally or by caesarean section or forceps, fulfilling all the inclusion criteria for MAS who were admitted to NICU, during the 9 months from January 2020 to September 2020 were included in the study. Over nine months' period, 574 neonates were admitted in NICU under that 312 neonates were in respiratory distress, out of which78 neonates were suffered with MAS. A detailed antenatal and natal history was elicited. Complications during delivery and details of resuscitation at birth, was done wherever required. Endo-tracheal intubation was done and bag and tube ventilation was given wherever needed. In MAS neonates, APGAR score at 1 minute and 5 minutes and gestational age was assessed with New Ballard’s score. A detailed clinical examination was carried out and respiratory distress was monitored by using Downes score system. Score > 6 was taken as an indication for assisted ventilation. 574 babies were admitted to NICU during the study period and out of them 312 were with respiratory distress. During the study period 78 (25%) babies had MAS. Conservative management was given to 59 cases (75.64%) and only 19 cases (24.36%) needed artificial ventilation, where indication was birth asphyxia, acute respiratory failure or other complications like pneumothorax. Out of 19 ventilated babies, 15 babies died and 4 babies survived and were discharged in good health. Conclusions: 1.Increased incidence of meconium aspiration syndrome was associated with increase in the gestational age (more in term and post term neonate, birth weight > 2.5kgs, 2. Highest mortality was associated with thick meconium and with low APGAR score at 5 minutes.

Meconium Aspiration Syndrome

2008 ◽  
Vol 27 (2) ◽  
pp. 81-87 ◽  
Author(s):  
Jeanne Ray Wiedemann ◽  
Andrea Saugstad ◽  
Laura Barnes-Powell ◽  
Karen Duran
Keyword(s):  
Respiratory Distress ◽  
Management Strategies ◽  
Meconium Aspiration Syndrome ◽  
Lung Compliance ◽  
Term Infants ◽  
Early Presentation ◽  
Radiographic Findings ◽  
Meconium Aspiration ◽  
Near Term ◽  
Meconium Stained Amniotic Fluid

Meconium aspiration syndrome (MAS) is one of the most common conditions associated with aspiration during the newborn period. MAS can be defined as respiratory distress in a neonate born through meconium-stained amniotic fluid (MSAF) with symptoms that cannot otherwise be explained. It can be characterized by early onset of respiratory distress in term and near-term infants delivered through MSAF. Early presentation includes respiratory symptoms such as respiratory distress, poor lung compliance, hypoxemia, and radiographic findings of hyperinflation and patchy opacifications. This article discusses the pathophysiology of MAS, historical and current prevention strategies, current management strategies, and prognoses for infants born through MSAF.

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