Meconium aspiration syndrome requiring assisted ventilation: perspective in a setting with limited resources

    loading  Checking for direct PDF access through Ovid

Abstract

To determine characteristics, management, complications and outcome of neonates with meconium aspiration syndrome (MAS) requiring mechanical ventilation (MV). A retrospective review of clinical data of neonates with MAS who were admitted to a public hospital for MV between January 2004 and December 2006. Eighty-eight neonates were ventilated for MAS. Thirty-one percent were postdates and 51% had no electronic fetal monitoring. Postnatal suctioning of meconium was not performed according to protocol in 47% of nonvigorous infants. High-frequency ventilation and surfactant were used in 32 and 14% of cases, respectively. Persistent pulmonary hypertension of the newborn (PPHN) and pneumothorax occurred in 57 and 24% of cases, respectively. Overall mortality rate was 33%. Neonates suffering from MAS with PPHN had higher mortality rate of 48% compared with 13% in those suffering from MAS without PPHN. Factors associated with mortality were peak inspiratory pressure (P<0.001), pneumothorax (P<0.001) and PPHN (P=0.001). Postdates, inadequate intrapartum monitoring and limited use of adjunct respiratory therapies were common. Severe MAS is associated with adverse outcome.

Related Topics

    loading  Loading Related Articles