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Tidal Volume Requirement in Mechanically Ventilated Infants with Meconium Aspiration Syndrome

Saumya Sharma1, Shane Clark2, Kabir Abubakar1

  • 1Division of Neonatology, Department of Pediatrics, Georgetown University Hospital, Washington, District of Columbia.

American Journal of Perinatology
|March 5, 2015
PubMed
Abstract

Insights

Infants with meconium aspiration syndrome (MAS) need higher tidal volumes (VT) and minute ventilation (MV) for adequate gas exchange. This study provides key reference data for selecting appropriate VT in MAS patients.

Area of Science:

  • Neonatology
  • Pediatric Pulmonology
  • Critical Care Medicine

Background:

  • Meconium aspiration syndrome (MAS) is associated with increased physiologic dead space and functional residual capacity.
  • These changes may necessitate higher ventilation parameters to achieve adequate gas exchange in affected infants.

Purpose of the Study:

  • To test the hypothesis that infants with MAS require higher tidal volumes (VT) for adequate ventilation.
  • To establish reference data for VT and minute ventilation (MV) in MAS.

Main Methods:

  • Retrospective review of infants with MAS managed with conventional ventilation (2000-2010).
  • Comparison with a control group of infants ventilated for other lung diseases.
  • Analysis of ventilator settings, VT, respiratory rate (RR), and blood gas values, focusing on achieving a partial pressure of carbon dioxide (Paco 2) between 35-60 mm Hg.

Main Results:

  • Infants with MAS required 26% higher VT and 42% higher MV compared to controls to maintain similar Paco 2 levels.
  • Birth weights were similar between MAS patients and controls.
  • Two patients in each group required extracorporeal membrane oxygenation.

Conclusions:

  • Infants with MAS require larger VT and higher total MV to achieve similar alveolar ventilation, aligning with the syndrome's pathophysiology.
  • This study offers the first reference data to guide VT selection in infants with MAS.

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