Abstract
The Meconium Aspiration Syndrome (MAS) is associated with alternations in fluid dynamics between the capillary and interstitial spaces. The role of oncotically active material in these changes was studied with serial COP, echocardiogram, chest X-ray and blood gases determination during the first 3 postnatal days in 7 infants with MAS. Their mean (X±SE) B.Wt. =3677 ± 181.8g and mean G.A. =40.7 ± 0.6 wks. Their results were compared to 7 healthy infants of similar B.Wt. and G.A. In the MAS infants the mean COP was 16.5 ± 0.5, 15.5 ± 0.6 and 16.8 ± 0.8 mmHg, and mean RPEP/RVET ratio was 0.58 ± 0.07, 0.39 ± 0.04 and 0.37 ± 0.05 for days 1,2, and 3 respectively. In healthy infants the mean COP was 16.8 ± 0.4, 18.6 ± 0.6 and 19.2 ± 0.7 mmHg while RPEP/RVET ratio was 0.35 ± 0.06, 0.32 ± 0.07 and 0.28 ±0.03 for the corresponding days. The initial fall and subsequent rise in COP with changes in RPEP/RVET ratio were concomitant with improvement in chest X-ray and FiO2 requirements. These findings support the hypothesis that MAS is associated with increased pulmonary hypertension and pulmonary vascular resistance. This rise in capillary pressure in the presence of hypoxic endothelial damage causes a leakage of fluid and colloids into the pulmonary interstitial space. With fall in capillary pressure, fluid and colloids re-enter the intravascular space.
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Udani, V., Wu, P., Siassi, B. et al. 1732 MECONIUM ASPIRATION SYNDROME AND CHANGES IN COLLOID OSMOTIC PRESSURE (COP). Pediatr Res 15 (Suppl 4), 732 (1981). https://doi.org/10.1203/00006450-198104001-01751
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DOI: https://doi.org/10.1203/00006450-198104001-01751