title: Current Concepts in the Management of Meconium Aspiration Syndrome.
abstract: In developing countries, meconium aspiration syndrome (MAS) is an important cause of morbidity and mortality among neonates. The concepts of pathophysiology and management of meconium stained amniotic fluid (MSAF) and meconium aspiration syndrome have undergone tremendous change in recent years. Routine intranatal and postnatal endotracheal suctioning of meconium in vigorous infants is no longer recommended. Recent studies have challenged its role even in non-vigorous infants. Supportive therapy like oxygen supplementation, mechanical ventilation and intravenous fluids are the cornerstone in the management of meconium aspiration syndrome. Availability of surfactant, inhaled nitric oxide, high frequency ventilators and extracorporeal membrane oxygenation has made it possible to salvage more infants with meconium aspiration syndrome. In this review the authors have discussed the current concepts in the pathophysiology and management of MAS. Drugs in trials and future therapeutic targets are also discussed briefly.
authors.affiliation: Department of Neonatology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605 006, India.
authors.forename: Subhash
authors.initials: S
authors.lastname: Chettri
authors.affiliation: Department of Neonatology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605 006, India. drvishnubhat@yahoo.com.
authors.forename: B Vishnu
authors.initials: BV
authors.lastname: Bhat
authors.affiliation: Department of Neonatology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605 006, India.
authors.forename: B
authors.initials: B
authors.lastname: Adhisivam
mesh_terms: D006801:Humans; D007231:Infant, Newborn; D008470:Meconium; D008471:Meconium Aspiration Syndrome / Q000628:therapy*; D011663:Pulmonary Surfactants; D012121:Respiration, Artificial; D013396:Suction
chemical_list: D011663:Pulmonary Surfactants
keywords: Endotracheal suction; Meconium aspiration syndrome; Nitric oxide; Surfactant