title: Surfactant lavage therapy for meconium aspiration syndrome: a systematic review and meta-analysis.
abstract: BACKGROUND
  Lung lavage with diluted surfactant has emerged as an innovative treatment for meconium aspiration syndrome (MAS). However, the treatment effect has not yet been fully established.
  
  
  OBJECTIVE
  To investigate the effects of surfactant lavage therapy for MAS by a systematic meta-analysis.
  
  
  METHODS
  Relevant studies were identified by database searches in MEDLINE (from 1950), EMBASE (from 1980), and CENTRAL, up to June 2010, and by additional hand searches. Meta-analyses were separately conducted for randomized controlled trials (RCTs) and non-randomized controlled studies (NRSs). Risk of bias was assessed and clinical as well as statistical heterogeneities were also investigated in explaining the potential bias.
  
  
  RESULTS
  Two RCTs (87 patients) and eight NRSs (178 patients) were identified. From the results of the meta-analysis of RCTs, surfactant lavage significantly decreased death or the need for extracorporeal membrane oxygenation (RR 0.34, 95% CI 0.11, 0.99). An interventional benefit was indicated for other outcomes, although it was not statistically significant based only on the two RCTs. Results from the analysis of outcomes from NRSs are consistent with those from RCTs and demonstrated a beneficial effect, which could be considered as supporting evidence.
  
  
  CONCLUSIONS
  Lung lavage with diluted surfactant appeared to improve the clinical outcome in infants with MAS. Given that less than 100 infants were included in the two RCTs, the findings of this study may still be regarded as insufficient evidence. Further research will be needed to confirm the benefit as well as to refine the lavage technique.
authors: Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors: Hyun Jin
authors: HJ
authors: Choi
authors: Seokyung
authors: S
authors: Hahn
authors: Joongyub
authors: J
authors: Lee
authors: Byung-Joo
authors: BJ
authors: Park
authors: Soon Min
authors: SM
authors: Lee
authors: Han-Suk
authors: HS
authors: Kim
authors: Chong-Woo
authors: CW
authors: Bae
mesh_terms: D001688:Biological Products / Q000008:administration & dosage / Q000627:therapeutic use*; D018893:Bronchoalveolar Lavage / Q000379:methods*; D004338:Drug Combinations; D005233:Fatty Alcohols / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D008471:Meconium Aspiration Syndrome / Q000188:drug therapy* / Q000401:mortality; D010715:Phosphatidylglycerols / Q000008:administration & dosage / Q000627:therapeutic use*; D011506:Proteins / Q000008:administration & dosage / Q000627:therapeutic use*; D011663:Pulmonary Surfactants / Q000008:administration & dosage / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D001688:Biological Products; D004338:Drug Combinations; D005233:Fatty Alcohols; D010715:Phosphatidylglycerols; D011506:Proteins; D011663:Pulmonary Surfactants; C502722:lucinactant; C072197:beractant