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Meconium aspiration syndrome: a comprehensive review

Journal of Perinatology volume 43, pages 1211–1221 (2023)Cite this article

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Abstract

Meconium aspiration syndrome (MAS) is a complex respiratory disease that continues to be associated with significant morbidities and mortality. The pathophysiological mechanisms of MAS include airway obstruction, local and systemic inflammation, surfactant inactivation and persistent pulmonary hypertension of the newborn (PPHN). Supplemental oxygen and non-invasive respiratory support are the main therapies for many patients. The management of the patients requiring invasive mechanical ventilation could be challenging because of the combination of atelectasis and air trapping. While studies have explored various ventilatory modalities, evidence to date does not clearly support any singular modality as superior. Patient’s pathophysiology, symptom severity, and clinician/unit expertise should guide the respiratory management. Early identification and concomitant management of PPHN is critically important as it contributes significantly to mortality and morbidities.

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Authors and Affiliations

  1. Department of Pediatrics, The Ohio State University and Nationwide Children’s Hospital, Columbus, OH, 43205, USA

    Ahmed Osman, Cecilie Halling, Namrita Odackal & Molly K. Ball

  2. Neonatal-Perinatal Fellowship Program, The Ohio State University and Nationwide Children’s Hospital, Columbus, OH, 43205, USA

    Mary Crume

  3. Pediatrics Residency Program, The Ohio State University and Nationwide Children’s Hospital, Columbus, OH, 43205, USA

    Hayat Al Tabosh

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  1. Ahmed Osman
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  2. Cecilie Halling
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Contributions

AO: conceptualized and designed the study, performed literature review, wrote sections of the manuscript, contributed to Table and Figure development, critically reviewed and revised all sections of the manuscript for important intellectual content, and oversaw the project. CH: conceptualized the manuscript, performed literature review, wrote sections of the manuscript, and critically reviewed and revised all sections of the manuscript for important intellectual content. MC: performed literature review, and wrote sections of the manuscript of the manuscript. HAT: performed literature review and wrote a section of the manuscript. NO: conceptualized and designed the illustrations, and critically reviewed and revised the manuscript for important intellectual content. MKB: conceptualized the manuscript, performed literature review, wrote sections of the manuscript, contributed to Table development, critically reviewed and revised all sections of the manuscript for important intellectual content, and oversaw trainee contributions. All authors approved the final manuscript as submitted and agree to be accountable for all aspect of the work.

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Correspondence to Ahmed Osman.

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Osman, A., Halling, C., Crume, M. et al. Meconium aspiration syndrome: a comprehensive review. J Perinatol 43, 1211–1221 (2023). https://doi.org/10.1038/s41372-023-01708-2

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