Surfactant Therapy in Severe Meconium Aspiration Syndrome.
- Author:
Sang Lak LEE
1
;
Chun Soo KIM
Author Information
- Publication Type:Multicenter Study ; Review
- Keywords: Meconium aspiration syndrome; Pulmonary surfactant
- MeSH: Hospitalization; Humans; Infant; Infant, Newborn; Meconium; Meconium Aspiration Syndrome; Oxygen; Pulmonary Surfactants; Respiratory Insufficiency; Suction; Therapeutic Irrigation; Ventilation
- From:Neonatal Medicine 2013;20(3):318-322
- CountryRepublic of Korea
- Language:Korean
- Abstract: Meconium is a strong inactivator of pulmonary surfactant. The deficiency of surfactant or surfactant dysfunction may contribute to respiratory failure in a wide group of disorders, including meconium aspiration syndrome (MAS). We reviewed the effect of pulmonary surfactant therapy for severe MAS in ours as well as other countries. In general, surfactant therapy improves pulmonary oxygenation (oxygenation index or arterial/alveolar oxygen tension) and reduces the requirement for ventilation, and oxygen supplementation or hospitalization time. However, its effects on mortality and pulmonary or extrapulmonary complications are variable. In Korean studies, outborn infants are five times more common than inborn infants; therefore, the initial hospital care at delivery including adequate tracheal suctioning is important to improve the outcome of patients with severe MAS. To confirm the effect of surfactant therapy in MAS, additional well-designed, multicenter, randomized, controlled trials are needed. In addition, determining the optimal type of surfactant therapy (bolus, lavage, or combined) and the appropriate dose and duration of therapy is important.
