Role of steroids on the clinical course and outcome of meconium aspiration syndrome-a randomized controlled trial.
BACKGROUND
Meconium aspiration syndrome (MAS) is one of the major causes of severe respiratory distress in the newborn and there is no uniform protocol of management after the development of MAS.


OBJECTIVE
The objective of the study was to determine whether systemic and inhalational steroid therapy can alter the clinical course of MAS and improve the outcome without causing any serious adverse effects.


METHODS
A randomized controlled trial was conducted in three groups of MAS over a period of 1 year. Group A (n = 33) served as controls, Group B (n = 34) received systemic methyl prednisolone and Group C (n = 32) received nebulized budesonide both for a period of 7 days starting after 24 h of age. Details of clinical progress were noted during the hospital stay. Follow up for a minimum period of 3 months was done in all. Data were analysed by SPSS 10 software. Student's t and ANOVA were used to assess statistical significance.


RESULTS
Patient profile was similar in all the three groups. Period of oxygen dependency and duration of hospital stay was significantly less in the steroid treated groups. Similarly full enteral feeding and radiological clearance of chest could be achieved earlier in groups B and C. No difference between the steroid treated groups could be appreciated by Student's Newman Kuel (SNK) test. Development of sepsis was similar in all the groups and no serious adverse effects were noted in steroid treated groups.


CONCLUSIONS
Steroids are effective in the management of MAS and route of administration does not have a bearing on the efficacy.
Basu
Sriparna
S
Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. drsriparnabasu@rediffmail.com
Kumar
Ashok
A
Bhatia
B D
BD
Satya
K
K
Singh
T B
TB
D000280:Administration, Inhalation; D000704:Analysis of Variance; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019819:Budesonide / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008471:Meconium Aspiration Syndrome / Q000188:drug therapy*; D008775:Methylprednisolone / Q000627:therapeutic use*; D011015:Pneumonia, Aspiration / Q000517:prevention & control; D012127:Respiratory Distress Syndrome, Newborn / Q000517:prevention & control
D000893:Anti-Inflammatory Agents; D019819:Budesonide; D008775:Methylprednisolone