Related Experiment Videos
[Relationship of chest roentgenographic features and outcome in meconium aspiration syndrome]
1Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C.
Insights
Meconium aspiration syndrome (MAS) in infants can cause respiratory distress. Initial chest X-rays are useful for diagnosis but cannot reliably predict patient outcomes in MAS.
Area of Science:
- Neonatal care
- Pediatric radiology
- Respiratory medicine
Background:
- Meconium aspiration syndrome (MAS) is a significant cause of respiratory distress in newborns.
- Early identification of prognostic indicators is crucial for managing MAS.
Purpose of the Study:
- To evaluate the correlation between initial chest roentgenogram findings and patient outcomes in infants diagnosed with MAS.
- To determine if early radiographic features can predict the severity and prognosis of MAS.
Main Methods:
- Retrospective analysis of clinical data and initial chest roentgenograms (obtained within 10 hours of birth) from 65 infants with MAS.
- Review of radiographic features including infiltration, consolidation, atelectasis, hyperinflation, air leak, and cardiomegaly.
- Correlation of radiographic findings with patient outcomes.
Main Results:
- The incidence of MAS was 0.33% with a mortality rate of 15.4% in the studied cohort.
- Infiltration was the most common finding (52 infants), followed by consolidation/atelectasis (18), hyperinflation (17), and air leak (11).
- No significant difference in outcome was observed between infants with infiltration, consolidation/atelectasis, hyperinflation, or air leak. Four infants with cardiomegaly had poor outcomes, but this was confounded by other factors like low initial blood gas pH.
Conclusions:
- Initial chest roentgenograms are valuable for diagnosing MAS and guiding treatment strategies.
- Early radiographic features, including common findings like infiltration or consolidation, are not reliable predictors of outcome in infants with MAS.
- While cardiomegaly may be associated with poorer outcomes, it is often influenced by multiple coexisting factors.
Abstract:
Aspiration of meconium may produce respiratory distress of various severity and outcome. It is the purpose of this study to evaluate the relationship between roentgenographic feature of initial chest roentgenogram (less than 10 hours old) and outcome in infants with meconium aspiration syndrome (MAS). We analyzed retrospectively the clinical data and initial chest roentgenograms of 65 infants who had MAS and who were admitted to NICU of Mackay Memorial Hospital in 1987. The incidence and the mortality rate in this hospital were 0.33% and 15.4% respectively. Infiltration was seen in 52, consolidation or atelectasis in 18, hyperinflation in 17, air leak in 11, and cardiomegaly in 4. The outcome was similar between infants with the first four features. Four infants with cardiomegaly also had other types of roentgenographic feature and PH value of initial blood gas less than 7.0, which means that their poor outcome was influenced by multiple factors. From this observation we concluded that the initial chest roentgenogram is a useful aid for the diagnosis and treatment of MAS, but it is not suitable for predicting the outcome of infants with MAS.