Modified Protocols for Surfactant Therapy in Experimental Meconium Aspiration Syndrome

Neonatology ◽  
2003 ◽  
Vol 83 (1) ◽  
pp. 49-56 ◽  
Author(s):  
Katsumi Tashiro ◽  
Xiao-Guang Cui ◽  
Tsutomu Kobayashi ◽  
Tore Curstedt ◽  
Bengt Robertson
Keyword(s):  
Meconium Aspiration Syndrome ◽  
Surfactant Therapy ◽  
Meconium Aspiration

Surfactant Therapy in Full-term Neonates With Severe Respiratory Failure

PEDIATRICS ◽  
1993 ◽  
Vol 92 (1) ◽  
pp. 135-139
Author(s):  
Hatem Khammash ◽  
Max Perlman ◽  
Julian Wojtulewicz ◽  
Michael Dunn
Keyword(s):  
Respiratory Failure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Oxygenation Index ◽  
Meconium Aspiration Syndrome ◽  
Full Term ◽  
Surfactant Therapy ◽  
Term Infants ◽  
Meconium Aspiration

Objective. In light of the paucity of published data on the use of surfactant in full-term infants with respiratory failure due to meconium aspiration syndrome and respiratory distress syndrome, we report our experience with this therapy. Our goal was to explore possible justification for randomized controlled trials of surfactant treatment in similar patients at an earlier, less severe stage of the disease. Methods. Retrospective consecutive case series of 20 infants with severe meconium aspiration syndrome and 29 infants with severe respiratory distress syndrome who received bovine surfactant between March 1990 and December 1992 in three neonatal intensive care units in a regionalized setting. Outcome of treatment was assessed by comparing changes in several respiratory indices including the oxygenation index, between 4 and 6 hours and 1 and 3 hours before and after the first dose of surfactant. Differences were analyzed using analysis of variance for repeated measures, with treatment and time as co-variates. Results. In the meconium aspiration group the mean oxygenation index decreased from 36 ± 12 at 1 to 3 hours presurfactant to 24 ± 14 at 1 to 3 hours postsurfactant (P < .001). In the patients with respiratory distress syndrome the mean oxygenation index fell from 30 ± 17 at 1 to 3 hours presurfactant to 12 ± 6 at 1 to 3 hours postsurfactant (P = .0001). Three of 20 patients with meconium aspiration syndrome and 3 of 29 patients with respiratory distress syndrome received extracorporeal membrane oxygenation. Conclusions. Surfactant therapy in full-term infants with respiratory failure due to the meconium aspiration and respiratory distress syndromes is often effective in improving gas exchange. A randomized controlled trial of surfactant therapy at an earlier stage in the course of the illness should be performed.

Surfactant therapy for meconium aspiration syndrome in neonates: a systematic overview of systematic reviews and recent clinical trials

2020 ◽  
Vol 9 (8) ◽  
pp. 527-536
Author(s):  
Mohammed Ahmed Abdelaal ◽  
Dina Abushanab ◽  
Daoud Al-Badriyeh
Keyword(s):  
Clinical Trials ◽  
Systematic Reviews ◽  
Lung Lavage ◽  
Meconium Aspiration Syndrome ◽  
Risk Of Bias ◽  
Surfactant Therapy ◽  
High Quality ◽  
Meconium Aspiration ◽  
Systematic Overview ◽  
Overview Of Systematic Reviews

Aim: To conduct a systematic overview of systematic reviews (SRs) and randomized clinical trials (RCTs) on surfactant therapy in neonatal meconium aspiration syndrome. Methods: We searched EMBASE, PROQUEST and PubMed to summarize the different effects of surfactant lung lavage and bolus surfactant therapies in neonates with meconium aspiration syndrome. Results: With a total of 1377 patients, three SRs and two RCTs were included in analysis. Surfactant effectiveness was concluded by low-quality SRs, with high risk of bias, which was contradicted by high-quality SRs, with low risk of bias. In SRs, the surfactant lung lavage reduced mortality, need for extracorporeal membrane oxygenation and hospitalization, while the bolus surfactant did not. In recent high-quality RCTs, however, the two modalities did not significantly differ. Conclusion: The evidence on surfactant effectiveness and its method of administration is sparse and inconsistent.

scholarly journals Surfactant Therapy and High-Frequency Jet Ventilation in the Management of a Piglet Model of the Meconium Aspiration Syndrome

1994 ◽  
Vol 36 (4) ◽  
pp. 494-500 ◽  
Author(s):  
Thomas E Wiswell ◽  
Samuel S Peabody ◽  
Jonathan M Davis ◽  
Michael V Slayter ◽  
Rebecca C Bent ◽  
...  
Keyword(s):  
High Frequency ◽  
Meconium Aspiration Syndrome ◽  
Surfactant Therapy ◽  
Jet Ventilation ◽  
Meconium Aspiration ◽  
High Frequency Jet Ventilation

Surfactant Therapy for Meconium Aspiration Syndrome

Drugs ◽  
2005 ◽  
Vol 65 (18) ◽  
pp. 2569-2591 ◽  
Author(s):  
Peter A Dargaville ◽  
John F Mills
Keyword(s):  
Meconium Aspiration Syndrome ◽  
Surfactant Therapy ◽  
Meconium Aspiration

scholarly journals N-Acetylcysteine Advancement of Surfactant Therapy in Experimental Meconium Aspiration Syndrome: Possible Mechanisms

2014 ◽  
pp. S629-S642 ◽  
Author(s):  
J. KOPINCOVÁ ◽  
D. MOKRÁ ◽  
P. MIKOLKA ◽  
M. KOLOMAZNÍK ◽  
A. ČALKOVSKÁ
Keyword(s):  
Oxidative Damage ◽  
Therapeutic Effect ◽  
Neutrophil Migration ◽  
Oxygenation Index ◽  
Meconium Aspiration Syndrome ◽  
Surfactant Therapy ◽  
Total Leukocyte Count ◽  
Exogenous Surfactant ◽  
Meconium Aspiration ◽  
Respiratory Parameters

Meconium aspiration syndrome (MAS) is meconium-induced respiratory failure of newborns associated with activation of inflammatory and oxidative pathways. For severe MAS, exogenous surfactant treatment is used which improves respiratory functions but does not treat the inflammation. Oxidative process can lead to later surfactant inactivation; hence, surfactant combination with antioxidative agent may enhance the therapeutic effect. Young New Zealand rabbits were instilled by meconium suspension and treated by surfactant alone, N-acetylcysteine (NAC) alone or by their combination and oxygen-ventilated for 5 h. Blood samples were taken before and 30 min after meconium application and 30 min, 1, 3 and 5 h after the treatment for evaluating of oxidative damage, total leukocyte count, leukocyte differential count and respiratory parameters. Leukocyte differential was assessed also in bronchoalveolar lavage fluid. NAC alone had only mild therapeutic effect on MAS. However, the combination of NAC and surfactant facilitated rapid onset of therapeutic effect in respiratory parameters (oxygenation index, PaO2/FiO2) compared to surfactant alone and was the only treatment which prevented neutrophil migration into the lungs, oxidative damage and lung edema. Moreover, NAC suppressed IL-8 and IL-β formation and thus seems to be favorable agent for improving surfactant therapy in MAS.

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