The role of early inhaled budesonide therapy in meconium aspiration in term newborns: a randomized control study.
OBJECTIVE
To study the clinical spectrum of Meconium aspiration syndrome babies and to find out the efficacy of early nebulized steroids (Budesonide) in the clinical course and outcome (morbidity and mortality) of neonates with meconium aspiration: randomized controlled trial.


METHODS
A total of 78 neonates were included in the study. After randomization, intervention group received nebulization with Budesonide (0.5 mg dissolved in 2.5-ml sterile normal saline within 2 h of birth and second dose was given at 12 h of birth) whereas controls were nebulized with normal saline. All neonates were accessed for serial respiratory distress score (Downe's score), requirement (dependence) of oxygen (in days), duration of neonatal intensive-care unit (NICU) stay, any complication and their final outcome.


RESULTS
The mean days of oxygen requirement for the cases and controls were 1.79 and 3.46, respectively (p < 0.001). The mean respiratory rate in intervention group up to the age of 5 d was significantly less (p value < 0.01). There was significant difference in mean Downe's score and mean duration of NICU stay in intervention group.


CONCLUSIONS
Budesonide nebulization in meconium aspiration results in significant early improvement in general condition (early improvement in respiratory distress and early normalization of Downe's score) of the newborn with lesser oxygen requirement, thus early discharge from NICU but has no impact on final outcome.
a General Hospital , Swaimadhopur , Rajasthan , India .
Neelmani
N
Garg
b Department of Medical and Paediatric Oncology , GCRI , Ahmedabad , Gujarat , India .
Mukesh
M
Choudhary
c Department of Neonatology , Fernandez Hospital , Hyderabad , India .
Deepak
D
Sharma
d Department of Paediatrics , Umaid Hospital, S.N Medical College , Jodhpur , Rajasthan , India .
Dhanraj
D
Dabi
e Bhagvan Mahaveer Hospital , Pitampura , New Delhi , India , and.
Jagveer Singh
JS
Choudhary
f Baba Sahib Amededkar Hospital , New Delhi , India.
Sushil Kumar
SK
Choudhary
D000280:Administration, Inhalation; D019819:Budesonide / Q000008:administration & dosage*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008471:Meconium Aspiration Syndrome / Q000188:drug therapy*; D012129:Respiratory Function Tests
D005938:Glucocorticoids; D019819:Budesonide
Budesonide; inhaled; meconium; newborn; normal saline