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Clinical characteristics of severe meconium aspiration syndrome

Korean Journal of Pediatrics 2008;51(7):713-721.
Published online July 15, 2008.
Clinical characteristics of severe meconium aspiration syndrome
Chang Won Choi, Beyong Il Kim, Hyun Ju Lee, Kyoung Eun Joung, Gyu Hong Shim, In Suk Lim, Jin-A Lee, Ee-Kyung Kim, Han-Suk Kim, Jung-Hwan Choi
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
중증 태변흡입증후군의 임상적 특성
최창원, 김병일, 이현주, 정경은, 심규홍, 임인숙, 이진아, 김이경, 김한석, 최중환
서울대학교 의과대학 소아과학교실
Correspondence: 
Beyong Il Kim, Email: beyil@snu.ac.kr
Abstract
Purpose
: This study aims to describe the clinical characteristics of severe meconium aspiration syndrome (MAS) which required mechanical ventilation over 48 h and to delineate the progress of respiratory failure and radiographic findings in severe MAS.
Methods
: Twelve infants admitted to the Neonatal Intensive Care Unit (NICU) of the Seoul National University Bundang Hospital diagnosed with severe MAS from January 2004 to July 2007 were analyzed retrospectively.
Results
: The presence of persistent pulmonary hypertension of the newborn (PPHN) is the only independently significant risk factor for a longer hospital stay and longer duration of mechanical ventilation. Surfactant replacement therapy (SRT) was not randomized but only performed in infants with radiographic findings for respiratory distress syndrome (RDS). In the presence of radiographic findings for RDS, the duration of high-frequency oscillatory ventilation was significantly longer. PPHN developed in 8 infants (75%). The PPHN group had a significantly longer duration of mechanical ventilation. All infants who received SRT showed radiographic improvement within 12 h, but there was no significant change in the severity score during the same period. Infants without the PPHN complications showed significant decrease in the severity score within 12 h after SRT, whereas infants with PPHN complications did not.
Conclusion
: The clinical course of severe MAS differed significantly depending on the development of PPHN. SRT conferred radiographic improvement in infants who showed radiographic findings for RDS, but did not influence the clinical course of MAS significantly.
Key Words: Meconium aspiration syndrome, Surfactant replacement therapy, Persistent pulmonary hypertension of the newborn


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