Effect of inhaled budesonide therapy in term newborns with meconium aspiration syndrome

Abstract

Background: Meconium aspiration syndrome is a common cause of respiratory distress in neonates. This study explores the possibility of altering the course of the disease by using anti-inflammatory agents to counter the chemical and inflammatory pneumonitis caused by meconium. The objective is to determine if inhaled budesonide therapy can alter the clinical course of the disease and improve outcome without causing any serious adverse effects. Methods: A comparative study was conducted in NICU of Cheluvamba hospital, Mysore over 12 months. Neonates with MAS were divided into interventional and control groups. Interventional group received budesonide nebulization 12th hourly starting after 6 hours of life, while control group received saline nebulization 12 hourly. Data was analysed by SPSS 20 software and student t test and chi square test were used to assess statistical significance. Results: The patient profile of the two groups was similar, with the interventional group showing early normalization of Downes score compared to controls. The duration of respiratory distress, oxygen dependency, and duration of hospital stay was significantly less in the steroid treated group compared to controls. There was no significant difference in the incidence of sepsis between the two groups, and three patients died during hospital stay due to pneumothorax with overwhelming sepsis with DIC. Conclusions: Nebulized budesonide improves clinical outcome in terms of morbidity and is relatively safe, however long term follow up required to recommend inhalational steroids as safe and effective.