<strong>Background:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Meconium aspiration syndrome (MAS) in the newborn is characte...<strong>Background:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Meconium aspiration syndrome (MAS) in the newborn is characterized by hypoxia, hypercapnia, and acidosis. MAS is a leading cause of morbidity and mortality in neonates. The primary objective of this study was to estimate the frequency of meconium aspiration syndrome (MAP) in babies born with meconium-stained liquor. The secondary outcome was to estimate the meconium aspiration syndrome;in terms of hospital stay, complications, and mortality. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">The study was done at Aga Khan Maternal and Child Care Centre, Hyderabad, Pakistan. Study design was case series and the duration of the study was of 6 months. All patients who fulfilled the inclusion criteria were included in the study after taking informed written consent. A brief history was taken, clinical examination was done and laboratory investigations were sent to the institutional laboratory. Study outcomes were measured from this data </span><i><span style="font-family:Verdana;">i</span></i><span style="font-family:Verdana;">.</span><i><span style="font-family:Verdana;">e</span></i><span style="font-family:Verdana;">. MAS, its complications, mortality, and a number of days in the hospital. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 87 babies</span><b><i> </i></b><span style="font-family:Verdana;">born with meconium-stained liquor at secondary care hospital were included. A total of 45 patients (52%) were males and 42 patients (48%) were females with a mean gestational age of babies 38.896 </span></span><span style="font-family:;" "=""><span style="font-family:Verdana;">± </span><span style="font-family:Verdana;">1.210 weeks. The mean Apgar score at 5 minutes was 8.896 </span><span style="font-family:Verdana;">± </span><span><span style="font-family:Verdana;">0.404. MAS was present in 13 patients (14.9%). Complications </span><span><span style="font-family:Verdana;">were seen only one patient (1.1%) and there was no neonatal death reported. </span><b><span style="font-family:Verdana;">Discussion: </span></b><span style="font-family:Verdana;">MAS</span><b> </b><span style="font-family:Verdana;">was present in 14.9% of babies;the complication of subacute bacterial infection was low seen in just 1.1% cases with no neonatal</span></span><span style="font-family:Verdana;"> mortality.</span></span></span>展开更多
Objective To investigate the factors in relation with the case fatality in severe meconium aspiration syndrome (MAS). Methods Eighty-one severe MAS cases intervened by the mechanical ventilation from 9 childrens hospi...Objective To investigate the factors in relation with the case fatality in severe meconium aspiration syndrome (MAS). Methods Eighty-one severe MAS cases intervened by the mechanical ventilation from 9 childrens hospitals were retrospectively analyzed for the risk factors of fatality with SAS software for non-parametric rank sum test and chi-square test. Results In the 81 cases, 49 were survived (death rate 39%). The gestational age (GA), Apgars score at 1min and other complications with MAS were significantly related to the death (P <0.05). There was no difference of death rate between the patients with or without receiving endotracheal intubation and airway suctioning (P>0.05). Conclusion A higher death rate (close to 40%) of severe MAS in the middle of 1990s in major cities of China suggests that it is important to detect the intrauterine hypoxemia as it may indicated by meconium staining amniotic fluid which should be intervened early by adequate termination of pregnancy before 42 weeks. The effects of delivery room suction and conventional ventilation also need to be reevaluated.展开更多
We demonstrated previously that inflammatory cy-tokines TNF, IL-1, IL-6 and IL-8 are signifi-cantly expressed in meconium-instilled lungs. Capto-pril was a strong inhibitor of meconium-induced lung injury, inflammatio...We demonstrated previously that inflammatory cy-tokines TNF, IL-1, IL-6 and IL-8 are signifi-cantly expressed in meconium-instilled lungs. Capto-pril was a strong inhibitor of meconium-induced lung injury, inflammation and apoptosis and reduces lung alveolar and airway epithelial cell damage. Presently we demonstrate that IL-13 expression in the me-conium aspiration syndrome (MAS). IL-13 was maximally expressed 8 hrs after meconium instilla-tion. It was previously described that IL-13 plays a major role in degradation of airway epithelial cells and inducing of lung fibrosis by activating collagen production that is a major point in identification of lung fibrosis. We also showed that Captopril treat-ment significantly inhibits IL-13 expression in the lungs. We believe it reduces meconium-induced lung injury and has a therapeutic effect on histological and biochemical functions of the lungs and possibly pulmonary fibrosis. Captopril treatment significantly reduced the number of neuprophils and macrophages which express IL13 and levels of other inflammatory cytokines after meconium instillation. Selective neu-tralization of IL-13 ameliorated lung injury, airway hyper responsiveness, eosinophil recruitment and mucus overproduction.展开更多
Laryngoscopy is a medical procedure that provides a secure airway by passing a breathing tube through the mouth and into the lungs of a patient, and to perform meconium suction in newborns to avoid asphyxia. The abili...Laryngoscopy is a medical procedure that provides a secure airway by passing a breathing tube through the mouth and into the lungs of a patient, and to perform meconium suction in newborns to avoid asphyxia. The ability to successfully perform meconium suction is highly dependent on operator skill and the availability of trained assistants to assist during the procedure. The immediate objective of this research paper is to present an improved device, so that the procedure can be performed at a faster pace and the need for assistants is eliminated. Experienced physicians have used the device presented in the paper on mannequin, and the operating time and ease were observed to have improved.展开更多
The Meconial Aspiration Syndrome (MAS) is a complication caused by the presence of meconium amniotic fluid with consequent aspiration, being responsible for important rates of perinatal morbidity and mortality. This s...The Meconial Aspiration Syndrome (MAS) is a complication caused by the presence of meconium amniotic fluid with consequent aspiration, being responsible for important rates of perinatal morbidity and mortality. This study aims to analyze the bibliographical production on newborn care with meconium elimination in the delivery room. It was a literature integrative review electronically based. Most of the studies referred to tracheal intubation and exogenous surfactant ministration as main care methods. The Meconium Aspiration Syndrome is presented as main theme. It is understood that health care professionals must develop knowledge, skills and actions, showing conduct based on scientific, critical and reflexive knowledge with purposeful interventions directed to the patient’s needs.展开更多
目的系统评价布地奈德联合肺表面活性物质(PS)治疗新生儿胎粪吸入综合征(MAS)的有效性与安全性。方法计算机检索PubMed、Cochrane Central Register of Controlled Trials(Central)、Embase、Web of Science、SinoMed、VIP、WanFang Dat...目的系统评价布地奈德联合肺表面活性物质(PS)治疗新生儿胎粪吸入综合征(MAS)的有效性与安全性。方法计算机检索PubMed、Cochrane Central Register of Controlled Trials(Central)、Embase、Web of Science、SinoMed、VIP、WanFang Data和CNKI数据库,搜集关于布地奈德联合PS治疗新生儿MAS的随机对照试验(RCT),检索时限均从建库至2023年9月2日。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4软件进行Meta分析。结果共纳入6个RCT,包括544例患儿。Meta分析结果显示,与单用PS相比,布地奈德联合PS治疗患儿的总有效率较高[RR=1.29,95%CI(1.17,1.41),P<0.001]、住院时间较短[MD=-6.35,95%CI(-9.25,-3.46),P<0.001]、吸氧时间较短[MD=-1.61,95%CI(-2.23,-0.98),P<0.001]、呼吸机使用时间较短[MD=-26.46,95%CI(-35.98,-16.95),P<0.001],治疗后各时段患儿的血气分析指标均改善(P<0.05);布地奈德联合PS组患儿总并发症及不良反应发生率明显低于单用PS组[RR=0.35,95%CI(0.25,0.47),P<0.001]。亚组分析显示,布地奈德联合PS组患儿的持续肺动脉高压(PPHN)发生率[RR=0.38,95%CI(0.19,0.74),P=0.004]、肺出血发生率[RR=0.26,95%CI(0.10,0.69),P=0.007]均低于单用PS组;两组心力衰竭、败血症发生率差异均无统计学意义(P>0.05)。结论当前证据显示,布地奈德联合PS治疗新生儿MAS可改善患儿的症状、体征、血气分析指标,加快病情康复,缩短病程,有助于降低并发症、PPHN、肺出血的发生风险,而不会增加心力衰竭、败血症的发生风险。但受纳入研究数量的限制,上述结论尚需更多高质量、大样本的RCT予以验证。展开更多
文摘<strong>Background:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Meconium aspiration syndrome (MAS) in the newborn is characterized by hypoxia, hypercapnia, and acidosis. MAS is a leading cause of morbidity and mortality in neonates. The primary objective of this study was to estimate the frequency of meconium aspiration syndrome (MAP) in babies born with meconium-stained liquor. The secondary outcome was to estimate the meconium aspiration syndrome;in terms of hospital stay, complications, and mortality. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">The study was done at Aga Khan Maternal and Child Care Centre, Hyderabad, Pakistan. Study design was case series and the duration of the study was of 6 months. All patients who fulfilled the inclusion criteria were included in the study after taking informed written consent. A brief history was taken, clinical examination was done and laboratory investigations were sent to the institutional laboratory. Study outcomes were measured from this data </span><i><span style="font-family:Verdana;">i</span></i><span style="font-family:Verdana;">.</span><i><span style="font-family:Verdana;">e</span></i><span style="font-family:Verdana;">. MAS, its complications, mortality, and a number of days in the hospital. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 87 babies</span><b><i> </i></b><span style="font-family:Verdana;">born with meconium-stained liquor at secondary care hospital were included. A total of 45 patients (52%) were males and 42 patients (48%) were females with a mean gestational age of babies 38.896 </span></span><span style="font-family:;" "=""><span style="font-family:Verdana;">± </span><span style="font-family:Verdana;">1.210 weeks. The mean Apgar score at 5 minutes was 8.896 </span><span style="font-family:Verdana;">± </span><span><span style="font-family:Verdana;">0.404. MAS was present in 13 patients (14.9%). Complications </span><span><span style="font-family:Verdana;">were seen only one patient (1.1%) and there was no neonatal death reported. </span><b><span style="font-family:Verdana;">Discussion: </span></b><span style="font-family:Verdana;">MAS</span><b> </b><span style="font-family:Verdana;">was present in 14.9% of babies;the complication of subacute bacterial infection was low seen in just 1.1% cases with no neonatal</span></span><span style="font-family:Verdana;"> mortality.</span></span></span>
文摘Objective To investigate the factors in relation with the case fatality in severe meconium aspiration syndrome (MAS). Methods Eighty-one severe MAS cases intervened by the mechanical ventilation from 9 childrens hospitals were retrospectively analyzed for the risk factors of fatality with SAS software for non-parametric rank sum test and chi-square test. Results In the 81 cases, 49 were survived (death rate 39%). The gestational age (GA), Apgars score at 1min and other complications with MAS were significantly related to the death (P <0.05). There was no difference of death rate between the patients with or without receiving endotracheal intubation and airway suctioning (P>0.05). Conclusion A higher death rate (close to 40%) of severe MAS in the middle of 1990s in major cities of China suggests that it is important to detect the intrauterine hypoxemia as it may indicated by meconium staining amniotic fluid which should be intervened early by adequate termination of pregnancy before 42 weeks. The effects of delivery room suction and conventional ventilation also need to be reevaluated.
文摘We demonstrated previously that inflammatory cy-tokines TNF, IL-1, IL-6 and IL-8 are signifi-cantly expressed in meconium-instilled lungs. Capto-pril was a strong inhibitor of meconium-induced lung injury, inflammation and apoptosis and reduces lung alveolar and airway epithelial cell damage. Presently we demonstrate that IL-13 expression in the me-conium aspiration syndrome (MAS). IL-13 was maximally expressed 8 hrs after meconium instilla-tion. It was previously described that IL-13 plays a major role in degradation of airway epithelial cells and inducing of lung fibrosis by activating collagen production that is a major point in identification of lung fibrosis. We also showed that Captopril treat-ment significantly inhibits IL-13 expression in the lungs. We believe it reduces meconium-induced lung injury and has a therapeutic effect on histological and biochemical functions of the lungs and possibly pulmonary fibrosis. Captopril treatment significantly reduced the number of neuprophils and macrophages which express IL13 and levels of other inflammatory cytokines after meconium instillation. Selective neu-tralization of IL-13 ameliorated lung injury, airway hyper responsiveness, eosinophil recruitment and mucus overproduction.
文摘Laryngoscopy is a medical procedure that provides a secure airway by passing a breathing tube through the mouth and into the lungs of a patient, and to perform meconium suction in newborns to avoid asphyxia. The ability to successfully perform meconium suction is highly dependent on operator skill and the availability of trained assistants to assist during the procedure. The immediate objective of this research paper is to present an improved device, so that the procedure can be performed at a faster pace and the need for assistants is eliminated. Experienced physicians have used the device presented in the paper on mannequin, and the operating time and ease were observed to have improved.
文摘The Meconial Aspiration Syndrome (MAS) is a complication caused by the presence of meconium amniotic fluid with consequent aspiration, being responsible for important rates of perinatal morbidity and mortality. This study aims to analyze the bibliographical production on newborn care with meconium elimination in the delivery room. It was a literature integrative review electronically based. Most of the studies referred to tracheal intubation and exogenous surfactant ministration as main care methods. The Meconium Aspiration Syndrome is presented as main theme. It is understood that health care professionals must develop knowledge, skills and actions, showing conduct based on scientific, critical and reflexive knowledge with purposeful interventions directed to the patient’s needs.
文摘目的系统评价布地奈德联合肺表面活性物质(PS)治疗新生儿胎粪吸入综合征(MAS)的有效性与安全性。方法计算机检索PubMed、Cochrane Central Register of Controlled Trials(Central)、Embase、Web of Science、SinoMed、VIP、WanFang Data和CNKI数据库,搜集关于布地奈德联合PS治疗新生儿MAS的随机对照试验(RCT),检索时限均从建库至2023年9月2日。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4软件进行Meta分析。结果共纳入6个RCT,包括544例患儿。Meta分析结果显示,与单用PS相比,布地奈德联合PS治疗患儿的总有效率较高[RR=1.29,95%CI(1.17,1.41),P<0.001]、住院时间较短[MD=-6.35,95%CI(-9.25,-3.46),P<0.001]、吸氧时间较短[MD=-1.61,95%CI(-2.23,-0.98),P<0.001]、呼吸机使用时间较短[MD=-26.46,95%CI(-35.98,-16.95),P<0.001],治疗后各时段患儿的血气分析指标均改善(P<0.05);布地奈德联合PS组患儿总并发症及不良反应发生率明显低于单用PS组[RR=0.35,95%CI(0.25,0.47),P<0.001]。亚组分析显示,布地奈德联合PS组患儿的持续肺动脉高压(PPHN)发生率[RR=0.38,95%CI(0.19,0.74),P=0.004]、肺出血发生率[RR=0.26,95%CI(0.10,0.69),P=0.007]均低于单用PS组;两组心力衰竭、败血症发生率差异均无统计学意义(P>0.05)。结论当前证据显示,布地奈德联合PS治疗新生儿MAS可改善患儿的症状、体征、血气分析指标,加快病情康复,缩短病程,有助于降低并发症、PPHN、肺出血的发生风险,而不会增加心力衰竭、败血症的发生风险。但受纳入研究数量的限制,上述结论尚需更多高质量、大样本的RCT予以验证。
