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Randomized controlled trial of lung lavage with dilute surfactant for Meconium Aspiration Syndrome

Citation

Dargaville, PA and Copnell, B and Mills, JF and Haron, I and Lee, JKF and Tingay, DG and Rohana, J and Mildenhall, LF and Jeng, M and Narayanan, A and Battin, MR and Kuschel, CA and Sadowsky, JL and Patel, H and Kilburn, CJ and Carlin, JB and Morley, CJ, Randomized controlled trial of lung lavage with dilute surfactant for Meconium Aspiration Syndrome, The Journal of Pediatrics, 158, (3) pp. 383-389. ISSN 0022-3476 (2011) [Refereed Article]


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Copyright Statement

Copyright 2011 Mosby Inc.

DOI: doi:10.1016/j.jpeds.2010.08.044

Abstract

Objective To evaluate whether lung lavage with surfactant changes the duration of mechanical respiratory support or other outcomes in meconium aspiration syndrome (MAS).

Study design We conducted a randomized controlled trial that enrolled ventilated infants with MAS. Infants randomized to lavage received two 15-mL/kg aliquots of dilute bovine surfactant instilled into, and recovered from, the lung. Control subjects received standard care, which in both groups included high frequency ventilation, nitric oxide, and, where available, extracorporeal membrane oxygenation (ECMO).

Results Sixty-six infants were randomized, with one ineligible infant excluded from analysis. Median duration of respiratory support was similar in infants who underwent lavage and control subjects (5.5 versus 6.0 days, P = .77). Requirement for high frequency ventilation and nitric oxide did not differ between the groups. Fewer infants who underwent lavage died or required ECMO: 10% (3/30) compared with 31% (11/35) in the control group (odds ratio, 0.24; 95% confidence interval, 0.060-0.97). Lavage transiently reduced oxygen saturation without substantial heart rate or blood pressure alterations. Mean airway pressure was more rapidly weaned in the lavage group after randomization.

Conclusion Lung lavage with dilute surfactant does not alter duration of respiratory support, but may reduce mortality, especially in units not offering ECMO

Item Details

Item Type:Refereed Article
Keywords:lung lavage, surfactant changes, mechanical respiratory support, meconium aspiration syndrome, MAS
Research Division:Biological Sciences
Research Group:Biochemistry and Cell Biology
Research Field:Proteomics and Intermolecular Interactions (excl. Medical Proteomics)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Infectious Diseases
Author:Dargaville, PA (Professor Peter Dargaville)
ID Code:78212
Year Published:2011
Web of Science® Times Cited:32
Deposited By:Menzies Institute for Medical Research
Deposited On:2012-06-18
Last Modified:2014-11-20
Downloads:2 View Download Statistics

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