| |
Background: Meconium aspiration syndrome (MAS) is frequently seen in term-gestation and post mature infants with severe asphyxia. Mechanical ventilation is currently used in the severe respiratory failure. A retrospective study was undertaken to explore the management of mechanical ventilation so as to reduce the complications and improve the cure rate in the treatment of newborn infants with MAS.
Methods: Sixty-eight patients were divided into groups A, B and C according to the time of admission. Group A, 17 infants, were treated from 1985 to 1989; group B, 25 infants from 1990 to 1995; and group C, 26 infants from 1996 to 2000 by the modified method. In these 3 groups, little difference was seen in the clinical data including sex, gestation, birth weight, and history of abnormal labor. In group C, 26 infants were also complicated by brain injury, 14 by heart failure, 11 by shock, 12 by renal failure, 3 by gastrointestinal dysfunction, and 3 by cardiopulmonary arrest.
Results: The cure rates in groups A, B and C were 23.5%, 60% and 96.2% respectively (H=20.8136, P <0.05, P<0.01). The prognosis rates in the 3 groups were 76.5%, 28% and 3.8%, respectively. The difference between the cure rates and poor prognosis rates among the 3 groups was statistically significant (H=25.55308, ¦Ö²=5.6210, P<0.01, P<0.05). In the three groups, 64.7%, 20% and 7.7% of infants developed pulmonary barotrauma, respectively; 76.5%, 72% and 19.2% infants had acid-base imbalance, and 50%, 25% and 12.5% infants had aggravation of pulmonary infection, respectively.
Conclusions: Strict sterilization and isolation are of utmost importance in mechanical ventilation for the treatment of MAS. The high cure rate of MAS is essential to the prevention of heart, brain, kidney, circulation and gastrointestinal dysfunction in newborn infants. Besides, the improvement of respiratory management as well as the prevention of complications is mostly dependent on the application of mechanical ventilator. According to the conditions of patients and the results of gas analysis, the ventilation parameter was adjusted timely. Improvement of cure rate, prognosis rate, and complications must be associated with the use of mechanical ventilator.
Key words: mechanical ventilation; newborn infants; meconium aspiration syndrome; complication management
|
