Related Experiment Video
Updated: Oct 23, 2026
Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Surfactant lavage for meconium aspiration syndrome: a pilot study
1Department of Paediatrics, University of Hong Kong, Hong Kong, China. lamccb@ha.org.hk
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.
Insights
Tracheobronchial lavage with diluted bovine lung surfactant solution (Survanta) shows promise for treating severe meconium aspiration syndrome (MAS) in infants. This pilot study indicates the procedure is safe and effective, reducing ventilation and oxygen needs.
Area of Science:
- Neonatal Medicine
- Pediatric Respiratory Medicine
- Critical Care
Background:
- Meconium aspiration syndrome (MAS) is a significant cause of respiratory distress and mortality in newborns.
- Current treatments for severe MAS often involve intensive respiratory support.
Purpose of the Study:
- To evaluate the safety and effectiveness of using diluted bovine lung surfactant (Survanta) as a tracheobronchial lavage fluid for infants with severe MAS.
- To gather preliminary data to support a future randomized controlled trial.
Main Methods:
- A pilot study involving six infants with severe MAS requiring mechanical ventilation.
- Treatment consisted of tracheobronchial lavage using 15 mL/kg of diluted Survanta (5 mg/mL phospholipid concentration).
- Outcomes were compared retrospectively to six historical control infants with similar MAS severity.
Main Results:
- Significant improvements were observed in oxygen index, mean airway pressure, and oxygenation within 48 hours post-lavage.
- Lavage-treated infants showed reduced durations of mechanical ventilation (55.3 vs. 131 hours) and oxygen therapy (4.1 vs. 20.8 days).
- All treated infants survived without sequelae; the procedure was well-tolerated with no complications.
Conclusions:
- Tracheobronchial lavage with diluted surfactant appears to be a safe and effective treatment for severe MAS.
- Further investigation through a multicenter randomized controlled trial is warranted to confirm these findings.
