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KMID : 1130320080510070713
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Korean Journal of Pediatrics
2008 Volume.51 No. 7 p.713 ~ p.721
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Clinical characteristics of severe meconium aspiration syndrome
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Chol Chang-Won
Kim Beyong-Il
Lee Hyun-Ju
Joung Kyoung-Eun
Shim Gyu-Hong
Im In-Suk
Lee Jin-A
Kim Ee-Kyung
Kim Han-Suk
Choi Jung-Hwan
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Abstract
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Purpose : This study aims to describe the clinical characteristics of severe meconium aspiration syndrome (MAS) which required mechanical ventilation over 48 h and to delineate the progress of respiratory failure and radiographic findings in severe MAS.
Methods : Twelve infants admitted to the Neonatal Intensive Care Unit (NICU) of the Seoul National University Bundang Hospital diagnosed with severe MAS from January 2004 to July 2007 were analyzed retrospectively.
Results : The presence of persistent pulmonary hypertension of the newborn (PPHN) is the only independently significant risk factor for a longer hospital stay and longer duration of mechanical ventilation. Surfactant replacement therapy (SRT) was not randomized but only performed in infants with radiographic findings for respiratory distress syndrome (RDS). In the presence of radiographic findings for RDS, the duration of high-frequency oscillatory ventilation was significantly longer. PPHN developed in 8 infants (75%). The PPHN group had a significantly longer duration of mechanical ventilation. All infants who received SRT showed radiographic improvement within 12 h, but there was no significant change in the severity score during the same period. Infants without the PPHN complications showed significant decrease in the severity score within 12 h after SRT, whereas infants with PPHN complications did not.
Conclusion : The clinical course of severe MAS differed significantly depending on the development of PPHN. SRT conferred radiographic improvement in infants who showed radiographic findings for RDS, but did not influence the clinical course of MAS significantly.
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KEYWORD
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Meconium aspiration syndrome, Surfactant replacement therapy, Persistent pulmonary hypertension of the newborn
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