Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Saline lavage with substitution of bovine surfactant in term neonates with meconium aspiration syndrome (MAS) transferred for extracorporeal membrane oxygenation (ECMO): a pilot study. | Research paper 19 Saline lavage with substitution of bovine surfactant in term neonates with meconium aspiration syndrome MAS transferred for extracorporeal membrane oxygenation ECMO a pilot study Jens C Moller Martina Kohl Irwin Reiss Wiebke Diederich Esther M Nitsche Wolfgang Gopel and Ludwig Gortner Background Meconium aspiration syndrome MAS is still a condition associated with a high mortality and many patients require extracorporeal membrane oxygenation ECMO as rescue therapy. Beneficial effects of surfactant and perflubron lavage have been reported. However pure surfactant supplementation has not been proven to be beneficial in the most severe forms of MAS. This study was performed to demonstrate an improvement in oxygenation in neonates transferred for ECMO and fulfilling ECMO criteria with a saline lavage and surfactant resupplementation. Methods Twelve newborns with MAS gestational age 36-40 weeks mean birth weight 3200 g age 4-16 h oxygenation index OI 40 transferred for ECMO therapy were treated with saline lavage 5-10cm3 kg body weight as long as green colored retrieval was observed and resupplementation with bovine surfactant Alveofact Boehringer Ingelheim Germany . The OI at admission and 3 h after this procedure was compared using the f-test for paired samples. ECMO was available as rescue therapy at all times. Results The OI decreased from SD to SD p . The decrease was sustained in nine patients three patients required ECMO and all patients survived. Conclusions As MAS is a condition with parenchymal damage pulmonary hypertension and obstructive airway disease no simple causative therapy is possible. Surfactant application after removal of meconium by extensive lavage is feasible as long as 16 h after birth even in infants considered for ECMO therapy it might reduce the necessity of ECMO. Addresses Klinik fur Padiatrie der Medizinischen Universitat Lubeck Lubeck Germany. Justus-Liebig-University Children s Hospital GieBen .
