Pulmonary function after surfactant lung lavage followed by surfactant administration in infants with severe meconium aspiration syndrome

Abstract

Objective: The effect of surfactant lung lavage (SLL) on pulmonary function was examined in neonates with severe form of meconium aspiration syndrome (MAS) (mean ± standard deviation: birth weight, 3178.1 ± 237.6 g; gestational age, 37.7 ± 1.8 weeks). Methods: The infants were on mechanical ventilation and were subjected to SLL with Survanta®. Dynamic compliance (Cdyn), airway resistance (Raw) and mean airway pressure (MAP) were obtained with use of the pneumotachometric method. Measurements of Cdyn, Raw, MAP and time constant (Tc) were compared in the study and control groups and between the groups before SLL and 24 and 48 h after SLL. Results: A significant increase in Cdyn (from 1.06 ± 0.23 to 2.12 ± 0.99 (ml/cmH2O)/kg) (p < 0.05) and a drop in both Raw (from 264.7 ± 41.5 to 146.6 ± 39.4 (cmH2O/l)/s) and MAP (from 12.4 ± 3.6 to 5.4 ± 2.1 cmH2O) were observed 48 hours after SLL. Conclusions: These data suggest that SLL is associated with a rapid and significant improvement in pulmonary mechanics, together with an improvement in oxygenation, in newborns with severe MAS. We found that the beneficial effects of SLL on pulmonary mechanics persisted for at least 48 h after introduction of the procedure.