Inhalations méconiales nécessitant une ventilation mécanique : incidence et prise en charge respiratoire en France (2000–2001)

Nolent, Paul; Hallalel, F; Chevalier, Jean-Yves; Flamant, Cyrille; Renolleau, Sylvain

doi:10.1016/j.arcped.2004.02.017

Cited by 14 publications

(3 citation statements)

References 22 publications

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“…Refinements in intensive care and respiratory support have contributed to a significant decrease in mortality related to MAS, with population-based studies now suggesting a mortality of 1-2 per 100,000 live births [36, 85, 86]. The case-fatality rate in ventilated infants with MAS varies widely in published series (0–37%) [37] and is influenced by availability of alternative means of ventilation, adjunctive therapies including nitric oxide, and ECMO.…”

Section: Outcome Of Ventilation In Masmentioning

confidence: 99%

“…The case-fatality rate in ventilated infants with MAS varies widely in published series (0–37%) [37] and is influenced by availability of alternative means of ventilation, adjunctive therapies including nitric oxide, and ECMO. Approximately one-quarter to one-third of all deaths in ventilated infants with a diagnosis of MAS are directly attributable to the pulmonary disease, with the remainder in large part caused by hypoxic-ischaemic encephalopathy [34, 36, 86]. …”

Section: Outcome Of Ventilation In Masmentioning

confidence: 99%

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Respiratory Support in Meconium Aspiration Syndrome: A Practical Guide

Dargaville

2012

International Journal of Pediatrics

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Meconium aspiration syndrome (MAS) is a complex respiratory disease of the term and near-term neonate. Inhalation of meconium causes airway obstruction, atelectasis, epithelial injury, surfactant inhibition, and pulmonary hypertension, the chief clinical manifestations of which are hypoxaemia and poor lung compliance. Supplemental oxygen is the mainstay of therapy for MAS, with around one-third of infants requiring intubation and mechanical ventilation. For those ventilated, high ventilator pressures, as well as a relatively long inspiratory time and slow ventilator rate, may be necessary to achieve adequate oxygenation. High-frequency ventilation may offer a benefit in infants with refractory hypoxaemia and/or gas trapping. Inhaled nitric oxide is effective in those with pulmonary hypertension, and other adjunctive therapies, including surfactant administration and lung lavage, should be considered in selected cases. With judicious use of available modes of ventilation and adjunctive therapies, infants with even the most severe MAS can usually be supported through the disease, with an acceptably low risk of short- and long-term morbidities.

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Section: Outcome Of Ventilation In Masmentioning

confidence: 99%

Section: Outcome Of Ventilation In Masmentioning

confidence: 99%

Respiratory Support in Meconium Aspiration Syndrome: A Practical Guide

Dargaville

2012

International Journal of Pediatrics

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“…In Australia, the rate of MAS requiring mechanical ventilation in level III units ranged between 0.024 to 0.046% at 36–40 WG and then increased to 0.080% at 41 WG and 0.14% at 42 WG [9]. In France, the prevalence of mechanically ventilated MAS was estimated to 0.043% by a retrospective national survey among neonates born in 2000-2001 [10]. …”

Section: Introductionmentioning

confidence: 99%

A Population-Based Study of Meconium Aspiration Syndrome in Neonates Born between 37 and 43 Weeks of Gestation

Fischer

Rybakowski

Ferdynus

et al. 2012

International Journal of Pediatrics

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The epidemiology of meconium aspiration syndrome (MAS) in term neonates is described in a population-based retrospective study of data recorded for all births from 2000 to 2007 in a French region (Burgundy). Of the 132 884 eligible term newborns, the rate of meconium-stained amniotic fluid (MSAF) was 7.93%. The prevalence of severe MAS was 0.067% in the overall population. MAS rate was 0.11% at 37-38 weeks of gestation (WG), 0.20% at 39–41 WG, and 0.49% at 42-43 WG. Factors independently associated with severe MAS were identified by a case-control study, that is, thick meconium amniotic fluid, fetal tachycardia, Apgar score ≤3 at 1 minute, and birth in a level III facility. Our results confirm the high prevalence of MSAF after 37 WG but also show the low frequency of severe MAS in a period corresponding to the new international recommendations on the management of birth with MSAF.

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