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Effect of surfactant lavage in severe meconium aspiration syndrome

Korean Journal of Pediatrics 2008;51(4):367-371.
Published online April 15, 2008.
Effect of surfactant lavage in severe meconium aspiration syndrome
Soon Min Lee, He Min Kim, Ji Hyun Jeon, Min Soo Park, Kook In Park, Ran Namgung, Chul Lee
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
중증 태변 흡인 증후군에서 인공 폐표면활성제 세정요법의 효과에 관한 비교 연구
이순민, 김혜민, 전지현, 박민수, 박국인, 남궁란, 이철
연세대학교 의과대학 소아과학교실
Correspondence: 
Min Soo Park, Email: minspark@yumc.yonsei.ac.kr
Abstract
Purpose
: The surfactant dysfunction may play an important role in meconium aspiration syndrome (MAS). We aim to evaluate the effect of surfactant lavage in the treatment of term infants with MAS.
Methods
: The medical records of 15 neonates with severe MAS admitted at Yongdong Severance Hospital from 2005 to 2007 were reviewed and analyzed. Seven infants with severe MAS necessitating mechanical ventilation underwent tracheobronchial lavage with 20 mL/kg of diluted (5.3 mg phospholipid/mL) surfactant saline suspension (Newfactan ). Data regarding clinical outcomes was assessed by comparison with 8 control infants with equally severe MAS retrospectively.
Results
: In the lavage group, radiological improvement was evident after 6 hours of treatment. The duration of artificial ventilation and duration of hospital day were also significantly shorten in the lavage group compared with the control group. The mean oxygen index, mean ventilation index improved significantly within the first 6 hours after treatment. No differences were found in the incidence of major complications and mortality between the two groups.
Conclusion
: The surfactant lavage seems to be an effective and safe method for treatment of severe MAS. A multicenter, large scaled randomized controlled trial is needed for further study.
Key Words: Bronchoalveolar lavage, Meconium aspiration, Pulmonary surfactant


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