Treatment of severe meconium aspiration syndrome with porcine surfactant. Collaborative Surfactant Study Group.
This study is based on clinical data from a retrospective series of 54 infants with meconium aspiration syndrome treated with porcine surfactant at a median age of 14 h (range 1-176 h). Median arterial/ alveolar oxygen tension ratio (a/A PO2 ratio) before treatment was 0.08 (range 0.02-0.23) and oxygenation index 25 (range 6-110). After treatment with surfactant at an initial dose of 50-200 mg/kg there was a modest but statistically significant increase in a/APO2 ratio associated with a reduction of oxygenation index. Ten (18%) babies showed a 3-4 fold increase in a/APO2 ratio within 1-2 h of treatment. Twenty-four (44%) babies showed little or no response by 1-2 h with the remaining infants showing modest improvement in oxygenation. One third of babies required repeated doses of surfactant. Twenty-eight day survival was 81%, with two babies requiring extracorporeal membrane oxygenation.


CONCLUSIONS
Natural surfactant treatment of severe meconium aspiration may prove to be a useful intervention and randomised controlled clinical trials should be undertaken.
Halliday
H L
HL
Royal Maternity Hospital, Belfast, Northern Ireland.
Speer
C P
CP
Robertson
B
B
D001688:Biological Products; D002245:Carbon Dioxide / Q000097:blood; D006801:Humans; D007231:Infant, Newborn; D008471:Meconium Aspiration Syndrome / Q000628:therapy*; D010100:Oxygen / Q000097:blood; D010743:Phospholipids; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D012121:Respiration, Artificial; D012189:Retrospective Studies; D016896:Treatment Outcome
D001688:Biological Products; D010743:Phospholipids; D011663:Pulmonary Surfactants; D002245:Carbon Dioxide; C068291:poractant alfa; D010100:Oxygen