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Treatment of MAS with PPHN using combined therapy: SLL, bolus surfactant and iNO

Journal of Perinatology volume 28, pages S56–S66 (2008)Cite this article

Abstract

The objective of the study was to compare the effectiveness of surfactant treatment either by bolus or surfactant lung lavage followed by inhaled nitric oxide (iNO) therapy in infants with meconium aspiration syndrome (MAS) complicated by persistent pulmonary hypertension (PPHN). In this study, thirteen infants with diagnosis of MAS and PPHN were first treated with conventional respiratory support. Then between 2 and 22h of life they were randomized either to bolus surfactant treatment (n=6) or surfactant lung lavage (SLL, n=7) treatment. Then all infants were treated with iNO therapy. The groups were compared with regard to their clinical course: changes in PaO2, FiO2, MAP, OI, A-a oxygen gradient, duration of iNO therapy, length of ventilation and hospitalization. Complications and mortality were also compared. The results showed that infants treated with SLL had significant improvements in oxygenation, decreases in MAP and A-a gradients. But there were no significant differences in duration of ventilation, iNO treatment, length of hospitalization or complications. In conclusion these data show no advantage of SLL therapy over bolus surfactant treatment in infants with MAS complicated by PPHN.

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Authors and Affiliations

  1. Department of Neonatology, University of Medical Sciences, Poznañ, Poland

    J Gadzinowski & K Kowalska

  2. Neonatal Division, Department of Pediatrics, UIC, Chicago, USA

    D Vidyasagar

Authors
  1. J Gadzinowski
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  2. K Kowalska
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  3. D Vidyasagar
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Correspondence to J Gadzinowski.

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J Gadzinowski has received consulting fees from Abbott. The remaining authors have declared no financial interests.

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Gadzinowski, J., Kowalska, K. & Vidyasagar, D. Treatment of MAS with PPHN using combined therapy: SLL, bolus surfactant and iNO. J Perinatol 28 (Suppl 3), S56–S66 (2008). https://doi.org/10.1038/jp.2008.163

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