Can nasal continuous positive airway pressure be used as primary respiratory support for infants with meconium aspiration syndrome?

Montgomery, Kelsey A; Rose, Rebecca S.

doi:10.1038/s41372-018-0256-y

Cited by 4 publications

(2 citation statements)

References 10 publications

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“…MAS is caused by chemical inflammation and alveolar mechanical obstruction caused by fetal inhalation of amniotic fluid mixed with meconium. The main clinical manifestations are respiratory distress and persistent pulmonary hypertension, with high mortality 1–4 . In clinical practice, ventilator support therapy is the main treatment for newborn infant MAS.…”

Section: Introductionmentioning

confidence: 99%

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A randomized single‐center controlled trial of synchronized intermittent mandatory ventilation with heliox in newborn infants with meconium aspiration syndrome

Tang²,

Shen

et al. 2021

Pediatric Pulmonology

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Objective This study aimed to investigate the beneficial effects of synchronized intermittent mandatory ventilation (SIMV) with heliox in newborn infants with meconium aspiration syndrome (MAS). Methods Seventy‐one newborn infants with MAS in the neonatal intensive care unit (NICU) of Daping Hospital of Army Medical University were enrolled in the trial. Infants treated with SIMV were randomized and divided into the heliox group (n = 35) and control group (n = 36). The heliox group received heliox for 6 h followed by air‐oxygen mixed gas, and the control group received air‐oxygen mixed gas. The primary outcome measures were PaO2/FiO2 (P/F) and the extubation time. The secondary outcome measures were the incidence of mechanical ventilation complications, hospital length of stay in the NICU, blood gas analysis, and inflammation markers. Results The P/F in the heliox group was significantly better than that in the control group (p < .001). The extubation time and hospital length of stay in the NICU in the heliox group were shorter than those in the control group (p < .001). The inflammation markers at 6 h and myocardial injury markers at 24 h were decreased compared with those at 0 h, and those in the heliox group were more significantly decreased than those in the control group ([interleukin {IL}‐6/IL‐8/tumor necrosis factor α] p < .001, [C‐reaction protein] p = .012; [creatine kinase] p < .001, [CK‐MB] p = .041). Conclusion Heliox appears to be more effective in reducing the length of ventilation and increasing carbon dioxide eliminations than an air‐oxygen mixture in infants with MAS under the support of SIMV.

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Section: Introductionmentioning

confidence: 99%

“…SIMV can effectively reduce airway pressure, alleviate extubation difficulty, and prevent alveolar atrophy. Hence, the SIMV mode has become an important respiratory support mode for newborn infant MAS 2,7–10 …”

Section: Introductionmentioning

confidence: 99%

A randomized single‐center controlled trial of synchronized intermittent mandatory ventilation with heliox in newborn infants with meconium aspiration syndrome

Tang²,

Shen

et al. 2021

Pediatric Pulmonology

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Meconium aspiration syndrome: a comprehensive review

Osman,

Halling,

Crume

et al. 2023

J Perinatol

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The Efficacy of CPAP in Neonates with Meconium Aspiration Syndrome: A Systematic Review and Meta-Analysis

et al. 2022

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Background: In neonates with meconium aspiration syndrome (MAS), continuous positive airway pressure (CPAP) may be more beneficial compared to endotracheal intubation (ETI). We evaluated the efficacy of CPAP in neonates with MAS. Methods: Four engines were used to search randomized clinical trials (RCTs). We used relative risk (RR) and mean difference (MD) with 95% confidence intervals (95%CI) to assess the effect on dichotomous and continuous outcomes, respectively. In addition, we used the Paule–Mandel (PM) random effects model due to the anticipated lack of events. Results: Three RCTs were included (n = 432). No significant difference was found in mortality (RR = 0.82; 95%CI = 0.54–1.25; I2 = 71%; p = 0.36), need for ventilation (RR = 0.49; 95%CI = 0.15–1.56; I2 = 71%; p = 0.57), and incidence of pneumothorax (RR = 1.24; 95%CI = 0.30–5.12; I2 = 0%; p = 0.77) in the CPAP group compared to the ETI group. Regarding secondary outcomes, compared to the ETI group, no significant differences were found in APGAR at one minute (MD = −1.01; 95%CI −2.97 to 0.94; I2 = 98%; p = 0.31), APGAR at 5 min (MD = −1.00; 95%CI = −2.96 to 0.95; I2 = 99%; p = 0.32), days of hospitalization (MD = −0.52; 95%CI = −1.46 to 0.42; I2 = 94%; p = 0.28), and cord pH (MD = 0.003; 95%CI = −0.01 to 0.02; I2 = 0%; p = 0.79). Conclusions: In patients with MAS, there is no significant effect of CPAP use compared to ETI on primary, specifically on mortality, need for ventilation, the incidence of pneumothorax, and secondary outcomes.

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Can nasal continuous positive airway pressure be used as primary respiratory support for infants with meconium aspiration syndrome?

Cited by 4 publications

References 10 publications

A randomized single‐center controlled trial of synchronized intermittent mandatory ventilation with heliox in newborn infants with meconium aspiration syndrome

A randomized single‐center controlled trial of synchronized intermittent mandatory ventilation with heliox in newborn infants with meconium aspiration syndrome

Meconium aspiration syndrome: a comprehensive review

The Efficacy of CPAP in Neonates with Meconium Aspiration Syndrome: A Systematic Review and Meta-Analysis

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