[Tracheobronchial lavage--a supplementary measure in the initial management of meconium aspiration syndrome].
Pulmonary lavage - a supplementary measure of resuscitation in newborn infants with severe aspiration of meconium stained amniotic fluid. During 1984-1985 150 mature newborn infants who had aspirated heavily-stained or pea soup-like amniotic fluid were resuscitated at the University Hospital of Obstetrics and Gynaecology in Graz. In 109 of these infants (controls) routine aspiration of both the upper and lower airways was accomplished as soon as possible, whilst in the remaining 41 infants (lavaged) pulmonary lavage with saline was additionally performed via an endotracheal tube after aspiration to clear the trachea and the upper bronchi from thick meconium which could not have been removed as efficiently otherwise. The incidence of manifest meconium aspiration syndrome was significantly higher (22%) in the lavaged infants than in the controls (8%). Mechanical ventilation was performed in 36% of the lavaged infants, whereas only 5.5% of the controls had to be ventilated for more than 1 hour. The mean duration of ventilation, however, was shorter (Mh = 5.1 hrs vs Mh = 69 hrs) and the average age at discharge lower in the lavaged. Three infants died, two of whom had severe malformations. Only one death in the lavaged infants was attributable to severe meconium aspiration syndrome already manifest at birth. Three infants (two lavaged, one control) showed radiological evidence of pneumothorax, but without clinical appearance of respiratory distress. Since the lavaged group naturally contained the more severely distressed infants, with a high incidence of caesarean section on account of intrauterine asphyxia and lower Apgar scores at one and five minutes, the high incidence of radiologically confirmed meconium aspiration syndrome was not surprising.(ABSTRACT TRUNCATED AT 250 WORDS)
Rosegger
H
H
Geburtshilflich-gynäkologische Universitätsklinik, Graz.
Engele
H
H
Haas
J
J
D001980:Bronchi; D003131:Combined Modality Therapy; D006801:Humans; D007231:Infant, Newborn; D008471:Meconium Aspiration Syndrome / Q000628:therapy*; D011379:Prognosis; D012151:Resuscitation / Q000379:methods*; D007507:Therapeutic Irrigation / Q000379:methods
Tracheobronchiallavage--eine ergänzende Massnahme zur Erstversorgung beim Mekoniumaspirationssyndrom.