Surfactant Therapy in Severe Meconium Aspiration Syndrome
- Author(s)
- Sang Lak Lee; Chun Soo Kim
- Keimyung Author(s)
- Lee, Sang Lak; Kim, Chun Soo
- Department
- Dept. of Pediatrics (소아청소년학)
- Journal Title
- Neonatal Medicine
- Issued Date
- 2013
- Volume
- 20
- Issue
- 3
- Keyword
- Meconium aspiration syndrome; Pulmonary surfactant
- Abstract
- Meconium is a strong inactivator of pulmonary surfactant. The deficiency of
surfactant or surfactant dysfunction may contribute to respiratory failure in a
wide group of disorders, including meconium aspiration syndrome (MAS). We
reviewed the effect of pulmonary surfactant therapy for severe MAS in ours as well
as other countries. In general, surfactant therapy improves pulmonary oxygenation
(oxygenation index or arterial/alveolar oxygen tension) and reduces the requirement
for ventilation, and oxygen supplementation or hospitalization time. However,
its effects on mortality and pulmonary or extrapulmonary complications are
variable. In Korean studies, outborn infants are five times more common than
inborn infants; therefore, the initial hospital care at delivery including adequate
tracheal suctioning is important to improve the outcome of patients with severe
MAS. To confirm the effect of surfactant therapy in MAS, additional well-designed,
multicenter, randomized, controlled trials are needed. In addition, determining the
optimal type of surfactant therapy (bolus, lavage, or combined) and the appropriate
dose and duration of therapy is important.
Key Words: Meconium aspiration syndrome, Pulmonary surfactant
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