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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Surfactant lavage for meconium aspiration syndrome: a pilot study.
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Surfactant lavage for meconium aspiration syndrome: a pilot study.

机译：胎粪吸入综合征的表面活性剂灌洗：一项初步研究。

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OBJECTIVE: Meconium aspiration syndrome (MAS) is a major cause of respiratory morbidity and mortality in term infants. We reported our pilot experience on the use of diluted bovine lung surfactant lipid extract solution (Survanta [Ross Laboratories, Ohio, USA]) as a tracheobronchial lavage fluid for the treatment of infants with severe MAS. Our goal was to establish the safety and the effectiveness of this procedure before organizing a randomized controlled trial. METHOD: Six infants with severe MAS necessitating mechanical ventilation with an oxygen index of >/=15 within 6 hours of life recruited consecutively during a 11/2-year period were treated with tracheobronchial lavage with 15 mL/kg of diluted surfactant solution (Survanta) at a phospholipid concentration of 5 mg/mL administered in 2-mL aliquots. The outcome of treatment was assessed by comparison with 6 consecutive historic control infants with equally severe MAS of similar inclusion criteria retrospectively. RESULTS: The mean oxygen index, mean airway pressure, fraction of inspired oxygen, and arterial/alveolar oxygen tension ratio improved significantly within the first 48 hours after treatment in the lavage group. The duration of ventilation (mean +/- SEM, 55.3 +/- 4.6 hours vs 131 +/- 60 hours) and oxygen therapy (mean +/- SEM, 4.1 +/- 0.5 days vs 20.8 +/- 8.2 days) were also significantly reduced in the lavage-treated group compared with the control group. All 6 patients in the lavage group survived without sequelae whereas there were 2 deaths in the control group. The process of administering the surfactant lavage was well tolerated with no air leak complications. CONCLUSIONS: Our experience suggested that surfactant lavage seems to be an effective and safe method for treatment of severe MAS. A multicenter randomized control trial is indicated to further study the efficacy of this treatment.
机译：目的：胎粪吸入综合征（MAS）是足月婴儿呼吸系统疾病和死亡的主要原因。我们报告了我们使用稀释牛肺表面活性剂脂质提取物溶液（Survanta [罗斯实验室，俄亥俄州，美国]）作为气管支气管灌洗液治疗重症MAS婴儿的试验经验。我们的目标是在组织随机对照试验之前确定该程序的安全性和有效性。方法：在11/2年内连续招募的6例严重MAS婴儿，需要在生命的6个小时内进行机械通气，氧指数> / = 15，在11/2年期间连续接受治疗，用气管支气管灌洗液稀释后的表面活性剂溶液为15 mL / kg（Survanta ）的磷脂浓度为5 mg / mL，以2 mL等分试样的形式给药。通过与6例具有相同纳入标准的同样严重的MAS的连续6例历史对照婴儿进行比较，对治疗结果进行评估。结果：灌洗组在治疗后的最初48小时内，平均氧指数，平均气道压力，吸入氧分数以及动脉/肺泡氧张力比显着改善。通气时间（平均+/- SEM，55.3 +/- 4.6小时vs 131 +/- 60小时）和氧气疗法（平均+/- SEM，4.1 +/- 0.5天vs 20.8 +/- 8.2天）为与对照组相比，灌洗液治疗组的血脂也明显减少。灌洗组中所有6例患者均存活，没有后遗症，而对照组中有2例死亡。表面活性剂灌洗的过程被很好地耐受，没有漏气的并发症。结论：我们的经验表明表面活性剂灌洗似乎是一种治疗重症MAS的有效和安全的方法。指示进行多中心随机对照试验以进一步研究该治疗的有效性。

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