[An effectiveness of surfactant lung lavage (SLL) in meconium aspiration syndrome (MAS)].

UNLABELLED: The aim of our study was to evaluate an effect of surfactant lung lavage (SLL) in severe meconium aspiration syndrome (MAS).

MATERIAL: 22 neonates were divided into 2 groups: group A treated with SLL (n = 11) and group B--historic control (n = 11). The criteria for entry into the study were as follows: stain amniotic fluid, meconium below vocal cords, gestational age > 35 wks, time after delivery < 6 h, clinical manifestation of severe respiratory insufficiency, need for mechanical ventilation (FiO2 > 0.4) and pathological chest X-ray.

METHOD: SLL was done between 1. and 6. hours of life with natural surfactant (Survanta) in concentration 5 mg of phospholipids/1 ml 0.9% NaCl (15 ml of solution per kg). Following data were analyzed IO, PaO2, FiO2 (before treatment and 1, 2, 4, 48 hours after), duration of hospitalization, death rate.

RESULTS: The mean value in group A (+/- SD) before SLL were as follow: IO 19.0 (12.4). PaO2--51.4 mmHg (14.1). FiO2--0.8 (0.3); after 1 hour: IO--13.7 (9.4). PaO2--63.8 mmHg (16.8). FiO2--0.7 (0.3). After 48 hours: IO--4.2 (2.4). PaO2--60.5 mmHg (7.2). FiO2--0.38 (0.1); duration of IMV--5.6 days (4.1); duration of hospitalization--20.5 days (8.8). No deaths occurred. In group B in 1st hour of life mean value (+/- SD) were as follows: IO 22.4 (14.5). PaO2--47.7 mmHg (12.1). FiO2--0.8 (10.3); after 1 hour: IO--21.5 (17.8). PaO2--52.2 mmHg (24.1). FiO2--0.7 (0.3); after 48 hours: IO--7.6 (5.8). PaO2--57.7 (16.4) mmHg. FiO2--0.5 (0.3); duration of IMV--5.9 days (4.8); duration of hospitalization--22.4 days (11.3). One newborn died in group B.

CONCLUSION: Our pilot SLL study showed the benefit of this procedure in newborns with severe MAS. In treating MAS, SLL allows to achieve lower IO and higher of PaO2 after 1 hour, shorten the time of mechanical ventilation and hospitalization.