title: Inflammatory indices in meconium aspiration syndrome.
abstract: BACKGROUND
  Meconium aspiration syndrome (MAS) is linked to inflammation, but data on the patterns of hematological indices and C-reactive protein (CRP) in MAS are lacking. The aim of the study was to evaluate CRP, white blood cell count (WBC), absolute neutrophil count (ANC), and immature-to-total neutrophil ratio (IT-ratio) in MAS and to assess their association with disease severity.
  
  
  METHODS
  Retrospective cross-sectional study including 239 consecutively admitted neonates with MAS to a level III NICU. Neonates with early onset sepsis were excluded. Results Neonates with severe MAS (invasive mechanical ventilation for <7 days) and very severe MAS (invasive mechanical ventilation for ≥7 days or high frequency ventilation or ECMO) had higher CRP and IT-ratio compared to neonates with non-severe MAS (no invasive mechanical ventilation) during the first 2 days of life (CRP: 13.0 and 40.9 vs. 9.5 mg/L, P = 0.039 and <0.001, respectively) and neonates with very severe MAS had lower WBC and ANC. All four inflammatory indices correlated significantly with duration of invasive mechanical ventilation, duration of respiratory support and with length of hospital stay, arterial hypotension, and persistent pulmonary hypertension. Neonates with all four inflammatory indices beyond the normal range had a more than 20-fold increase in risk for very severe MAS.
  
  
  CONCLUSIONS
  High CRP and IT-ratio and low WBC and ANC values were closely linked to a more severe course of MAS during the early phases of the disease. These findings reflect the role of inflammation in the pathogenesis of MAS. Pediatr Pulmonol. 2016;51:601-606. 2015 Wiley Periodicals, Inc.
authors.affiliation: Pediatric Intensive Care Unit, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.|Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz, Graz, Austria.
authors.forename: Nora
authors.initials: N
authors.lastname: Hofer
authors.affiliation: Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz, Graz, Austria.
authors.forename: Katharina
authors.initials: K
authors.lastname: Jank
authors.affiliation: Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz, Graz, Austria.
authors.forename: Volker
authors.initials: V
authors.lastname: Strenger
authors.affiliation: Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Pansy
authors.affiliation: Research Unit for Neonatal Infectious Diseases and Epidemiology, Medical University of Graz, Graz, Austria.|Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Resch
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006612:High-Frequency Ventilation; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007902:Length of Stay; D008471:Meconium Aspiration Syndrome / Q000150:complications / Q000276:immunology* / Q000628:therapy; D012121:Respiration, Artificial / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: IT-ratio; absolute neutrophil count; white blood cell count