Inês Silva Costa, Jose Alarcão, Ana Rodrigues Silva, Raquel Henriques
Unidade Local de Saúde (ULS) de Viseu Dão-Lafões. Unidade Local de Saúde (ULS) de Coimbra.
Portugal
Cureus
Cureus 2024; 16:
DOI: 10.7759/cureus.72894
Abstract
Introduction: Meconium aspiration syndrome (MAS) is a respiratory condition associated with high morbimortality. Standards of care changed over the years addressing its specificities, aiming to decrease poor respiratory and neurologic long-term outcomes. This study aims to compare the practice and outcomes of MAS in a level III neonatal intensive care unit before and after the revision of the 2015 Neonatal Resuscitation Program (NRP).
Methods: A 15-year retrospective cohort of patients with MAS was assessed regarding perinatal management, clinical outcome, and neurodevelopmental follow-up.
Results: A total of 52 MAS occurred, 51.9% (n=27) male gender, median gestational age 40 weeks (IQR 39-40), and mean birth weight of 3395±503 g. Recommendations of the NRP were implemented with a significant change in the management in the delivery room, as positive pressure ventilation was more frequent (p=0.001). No significant change was found in the clinical span or morbidity of MAS after NRP, except for lower acidosis (pH 7.0 vs. 7.2; p=0.042) and lower hyperlactatemia (12.2 vs. 6.4 mmol/l; p=0.035). Overall acute complications included pulmonary hypertension (21.2%, n=11) and pneumothorax (15.4%, n=8). To date, morbidity during follow-up didn’t differ after NRP concerning global development delay (p=0.591), neurologic sequelae (p=0.276), and recurrent bronchospasm (p=0.614), in contrast with speech delay, which was less frequent in the later subgroup (p=0.023).
Conclusions: SAM persists as a concerning condition. From our data, the NRP showed no inferiority in the clinical outcomes, consistent with the literature but with higher frequency. Late morbidity is still a problem concerning cerebral palsy and global development delay, similar to known data.
Category
Class I. Persistent Pulmonary Hypertension of the Newborn
Class III. Pulmonary Hypertension Associated with Lung Disease
Symptoms and Findings Associated with Pulmonary Vascular Disease
Quality of Life Associated with Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes