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Billie L. Short - One of the best experts on this subject based on the ideXlab platform.

Peter A. Dargaville - One of the best experts on this subject based on the ideXlab platform.

  • fluid recovery during lung lavage in Meconium Aspiration Syndrome
    Acta Paediatrica, 2013
    Co-Authors: Peter A. Dargaville, Beverley Copnell, David G. Tingay, John F. Mills, Ismail Haron, Jimmy Kf Lee, Jaafar Rohana, Lindsay Mildenhall, Meijy Jeng
    Abstract:

    Lung lavage using two aliquots of 15 mL/kg of dilute surfactant was performed in 30 ventilated infants with severe Meconium Aspiration Syndrome (MAS). Mean recovery of instilled lavage fluid was 46%, with greater fluid return associated with lower mean airway pressure at 24 h and a shorter duration of respiratory support. Conclusion: Recovery of instilled lavage fluid is paramount in effective lung lavage in MAS and must be afforded priority in the lavage technique.

  • Refining the method of therapeutic lung lavage in Meconium Aspiration Syndrome
    Neonatology, 2008
    Co-Authors: Peter A. Dargaville, Beverley Copnell, David G. Tingay, Michael J. Gordon, John F. Mills, Colin J Morley
    Abstract:

    Background: Therapeutic lung lavage is an emerging treatment for Meconium Aspiration Syndrome (MAS), but the ideal fluid volume and lavage technique remain unclear. Objecti

  • Surfactant and surfactant inhibitors in Meconium Aspiration Syndrome.
    The Journal of pediatrics, 2001
    Co-Authors: Peter A. Dargaville, Mike South, Peter N Mcdougall
    Abstract:

    Surfactant indices and inhibitors were measured in lung lavage fluid from 8 infants with Meconium Aspiration Syndrome (MAS) who were receiving mechanical ventilation and 11 healthy control subjects. Surfactant phospholipid and surfactant protein A content in MAS was not different from that of control subjects, but concentrations of total protein, albumin, and membrane-derived phospholipid were elevated. All infants with MAS had hemorrhagic pulmonary edema. These findings reinforce the notion of MAS as a toxic pneumonitis with epithelial disruption and proteinaceous exudation.

  • surfactant for Meconium Aspiration Syndrome in full term infants
    Cochrane Database of Systematic Reviews, 2000
    Co-Authors: Roger F Soll, Peter A. Dargaville
    Abstract:

    OBJECTIVES To evaluate the effect of surfactant administration in the treatment of term infants with Meconium Aspiration Syndrome. SEARCH STRATEGY Searches were made using Medline (1985 to January 2000) (MeSH terms: pulmonary surfactant and Meconium Aspiration; limits: age groups, newborns; publication type, clinical trials), previous reviews including cross-references, abstracts, conference and symposia proceedings, expert informants, and journal hand searching in the English language. Authors were directly contacted to provide additional data. SELECTION CRITERIA Randomized controlled trials which evaluated the effect of surfactant administration in term infants with Meconium Aspiration Syndrome are included in the analysis. DATA COLLECTION AND ANALYSIS Data regarding clinical outcomes including duration of assisted ventilation, duration of supplemental oxygen, pneumothorax, intraventricular hemorrhage (any grade and severe IVH), chronic lung disease, treatment with extracorporeal membrane oxygenation (ECMO), and mortality were excerpted from the reports of the clinical trails by the reviewers. Data analysis was done in accordance with the standards of the Cochrane Neonatal Review Group. MAIN RESULTS Two randomized controlled trials met inclusion criteria. Findlay (1996) reports a decrease in the risk of pneumothorax (relative risk 0.09, 95% CI 0.01, 1.54, risk difference -0.25, 95% CI -0.45, -0.05). Both Findlay (1996) and Lotze (1998) report a decrease in the number of infants receiving extracorporeal membrane oxygenation. The meta-analysis supports a significant reduction in the risk of requiring extracorporeal membrane oxygenation (typical relative risk 0.64, 95% CI 0.46, 0.91 typical risk difference -0.17, 95% CI -0.30, -0.04). No difference was noted in overall mortality (typical relative risk 1.86 95% CI 0.35, 9.89, typical risk difference 0.02 95% CI -0.03, 0.07). REVIEWER'S CONCLUSIONS In infants with Meconium Aspiration Syndrome, surfactant administration may reduce the severity of respiratory illness and decrease the number of infants with progressive respiratory failure requiring support with ECMO. The relative efficacy of surfactant therapy compared to, or in conjunction with, other approaches to treatment including inhaled nitric oxide, liquid ventilation, and high frequency ventilation remains to be tested.

Kwang-sun Lee - One of the best experts on this subject based on the ideXlab platform.

  • Racial disparity in Meconium-stained amniotic fluid and Meconium Aspiration Syndrome in the United States, 1989–2000
    Obstetrics & Gynecology, 2003
    Co-Authors: Sudhir Sriram, Stephen N Wall, Babak Khoshnood, Jaideep K Singh, Hui-lung Hsieh, Kwang-sun Lee
    Abstract:

    Abstract Objective To estimate the prevalence of Meconium-stained amniotic fluid and Meconium Aspiration Syndrome, as well as the differences in case fatality from Meconium Aspiration Syndrome, between non-Hispanic black and non-Hispanic white infants. Methods We studied non-Hispanic black and non-Hispanic white live births with weights greater than 2.5 kg and gestational ages greater than 35 weeks, using the linked US birth and infant death cohorts for three periods: 1989–1991, 1995–1997, and 1998–2000. We used logistic regression to estimate the risks of Meconium-stained amniotic fluid and Meconium Aspiration Syndrome and to estimate the case fatality of Meconium Aspiration Syndrome by maternal race, birth weight, period, and pregnancy complications. Results Risk of Meconium-stained amniotic fluid was 80% higher in non-Hispanic blacks when compared with non-Hispanic whites (birth weight–adjusted odds ratio [OR], 1.81, 95% confidence interval [CI] 1.80, 1.82). The prevalence of pregnancy complications did not explain this racial disparity. Risk of Meconium Aspiration Syndrome in non-Hispanic blacks was 67% higher when compared with non-Hispanic whites (birth weight–adjusted OR 1.67, 95% CI 1.64, 1.70). The case fatality rate of Meconium Aspiration Syndrome was similar between non-Hispanic blacks and non-Hispanic whites in the three periods, with rates of 15.5, 15.2, and 11.2 per 1000 in non-Hispanic blacks and 13.5, 11.2, and 10.1 per 1000 in non-Hispanic whites in 1989–1991, 1995–1997, and 1998–2000, respectively. Conclusion Our results suggest that when compared with non-Hispanic whites, non-Hispanic blacks are at significantly greater risk for Meconium-stained amniotic fluid and Meconium Aspiration Syndrome but not for Meconium Aspiration Syndrome case fatality.

  • racial disparity in Meconium stained amniotic fluid and Meconium Aspiration Syndrome in the united states 1989 2000
    Obstetrics & Gynecology, 2003
    Co-Authors: Sudhir Sriram, Stephen N Wall, Babak Khoshnood, Jaideep K Singh, Hui-lung Hsieh, Kwang-sun Lee
    Abstract:

    Abstract Objective To estimate the prevalence of Meconium-stained amniotic fluid and Meconium Aspiration Syndrome, as well as the differences in case fatality from Meconium Aspiration Syndrome, between non-Hispanic black and non-Hispanic white infants. Methods We studied non-Hispanic black and non-Hispanic white live births with weights greater than 2.5 kg and gestational ages greater than 35 weeks, using the linked US birth and infant death cohorts for three periods: 1989–1991, 1995–1997, and 1998–2000. We used logistic regression to estimate the risks of Meconium-stained amniotic fluid and Meconium Aspiration Syndrome and to estimate the case fatality of Meconium Aspiration Syndrome by maternal race, birth weight, period, and pregnancy complications. Results Risk of Meconium-stained amniotic fluid was 80% higher in non-Hispanic blacks when compared with non-Hispanic whites (birth weight–adjusted odds ratio [OR], 1.81, 95% confidence interval [CI] 1.80, 1.82). The prevalence of pregnancy complications did not explain this racial disparity. Risk of Meconium Aspiration Syndrome in non-Hispanic blacks was 67% higher when compared with non-Hispanic whites (birth weight–adjusted OR 1.67, 95% CI 1.64, 1.70). The case fatality rate of Meconium Aspiration Syndrome was similar between non-Hispanic blacks and non-Hispanic whites in the three periods, with rates of 15.5, 15.2, and 11.2 per 1000 in non-Hispanic blacks and 13.5, 11.2, and 10.1 per 1000 in non-Hispanic whites in 1989–1991, 1995–1997, and 1998–2000, respectively. Conclusion Our results suggest that when compared with non-Hispanic whites, non-Hispanic blacks are at significantly greater risk for Meconium-stained amniotic fluid and Meconium Aspiration Syndrome but not for Meconium Aspiration Syndrome case fatality.

Khodavar Rais-bahrami - One of the best experts on this subject based on the ideXlab platform.

Michael C Gordon - One of the best experts on this subject based on the ideXlab platform.

  • changing obstetric practices associated with decreasing incidence of Meconium Aspiration Syndrome
    Obstetrics & Gynecology, 2002
    Co-Authors: Bradley A Yoder, Erica A Kirsch, William H Barth, Michael C Gordon
    Abstract:

    OBJECTIVE: To describe changes in neonatal and obstetric practices that may have contributed to the decreasing incidence of Meconium Aspiration Syndrome in our population during this time. METHODS: We compared neonatal and obstetric characteristics of 61 infants diagnosed with Meconium Aspiration Syndrome with 1365 infants born through moderate or thick Meconium-stained amniotic fluid at more than 37 weeks’ completed gestation. Data were prospectively collected, and all respiratory diagnoses were concurrently made. Three distinct birth year groups were analyzed based on changing obstetric practice paradigms. RESULTS: Meconium Aspiration Syndrome decreased nearly four-fold from 1990–1992 to 1997–1998 (5.8% to 1.5% of Meconium-stained infants more than 37 weeks; P < .003). The only change in neonatal characteristics was a 33% decrease in births more than 41 weeks with a reciprocal 33% increase in births 38–39 weeks during 1997–1998. Significant changes in obstetric practice included more frequent diagnosis of nonreassuring fetal heart rate patterns, greater use of amnioinfusion, and increased cesarean delivery rate in 1997–1998. By logistic regression analysis, the only consistent risk factor for Meconium Aspiration Syndrome across all three epochs was the presence of tracheal Meconium. CONCLUSION: Reduction in post-term delivery was the most important factor in reducing Meconium Aspiration Syndrome.

  • Changing obstetric practices associated with decreasing incidence of Meconium Aspiration Syndrome.
    Obstetrics and gynecology, 2002
    Co-Authors: Bradley A Yoder, Erica A Kirsch, William H Barth, Michael C Gordon
    Abstract:

    To describe changes in neonatal and obstetric practices that may have contributed to the decreasing incidence of Meconium Aspiration Syndrome in our population during this time. We compared neonatal and obstetric characteristics of 61 infants diagnosed with Meconium Aspiration Syndrome with 1365 infants born through moderate or thick Meconium-stained amniotic fluid at more than 37 weeks' completed gestation. Data were prospectively collected, and all respiratory diagnoses were concurrently made. Three distinct birth year groups were analyzed based on changing obstetric practice paradigms. Meconium Aspiration Syndrome decreased nearly four-fold from 1990-1992 to 1997-1998 (5.8% to 1.5% of Meconium-stained infants more than 37 weeks; P <.003). The only change in neonatal characteristics was a 33% decrease in births more than 41 weeks with a reciprocal 33% increase in births 38-39 weeks during 1997-1998. Significant changes in obstetric practice included more frequent diagnosis of nonreassuring fetal heart rate patterns, greater use of amnioinfusion, and increased cesarean delivery rate in 1997-1998. By logistic regression analysis, the only consistent risk factor for Meconium Aspiration Syndrome across all three epochs was the presence of tracheal Meconium. Reduction in post-term delivery was the most important factor in reducing Meconium Aspiration Syndrome.