All issues > Volume 51(7); 2008

Original Article

Korean J Pediatr. 2008;51(7):713-721. Published online July 15, 2008.

Clinical characteristics of severe meconium aspiration syndrome

Chang Won CW Choi¹, Beyong Il BI Kim¹, Hyun Ju HJ Lee¹, Kyoung Eun KE Joung¹, Gyu Hong GH Shim¹, In Suk IS Lim¹, Jin-A JA Lee¹, Ee-Kyung EK Kim¹, Han-Suk HS Kim¹, Jung-Hwan JH Choi¹

¹Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea

Correspondence Beyong Il BI 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.

Keywords :Meconium aspiration syndrome, Surfactant replacement therapy, Persistent pulmonary hypertension of the newborn