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Absence of long term pulmonary sequelae after mild meconium aspiration syndrome
J C Stevens1, H Eigen, D Wysomierski
1Department of Pediatrics, James Whitcomb Riley Hospital for Children, Indianapolis, Indiana 46223.
Insights
Children with mild meconium aspiration syndrome (MAS) show no long-term lung damage. Pulmonary function tests at age 7.4 years revealed no significant differences compared to healthy children.
Area of Science:
- Pediatric Pulmonology
- Neonatal Intensive Care
- Respiratory Medicine
Background:
- Meconium aspiration syndrome (MAS) can potentially lead to long-term respiratory complications.
- Assessing residual lung damage in children with a history of MAS is crucial for understanding prognosis.
Purpose of the Study:
- To evaluate the long-term pulmonary function in children who experienced mild to moderate meconium aspiration syndrome.
- To identify any residual lung damage or sequelae years after the initial illness.
Main Methods:
- Pulmonary function tests including FVC, FEV1, PEFR, MMEFR, VisoV, lung volumes, and DLCO were performed.
- Methacholine bronchial challenge testing was conducted to assess airway hyperresponsiveness.
- Results were compared to a control group of healthy children.
Main Results:
- No significant differences were observed in most pulmonary function parameters between MAS patients and controls.
- A statistically significant increase in VisoV (maximal mid-expiratory flow rate) was noted in MAS patients, though its clinical significance is uncertain due to variability.
- No evidence of significant small airway disease or bronchial hyperresponsiveness was found.
Conclusions:
- Children with mild to moderate meconium aspiration syndrome appear to have no significant pulmonary sequelae at an average follow-up of 7.4 years.
- The isolated finding of increased VisoV in MAS patients is likely not indicative of clinically relevant small airway disease.
Abstract:
To assess residual damage from meconium aspiration syndrome (MAS), we studied 12 children, ages 6 to 9 years, an average of 7.4 years after injury. Our sample consisted of mildly affected patients, only one having required intubation and mechanical ventilation in the acute phase of illness. In each child we measured FVC, FEV1, PEFR, MMEFR, VisoV, lung volumes by plethysmography, DLCO and calculated FEV1/FVC and RV/TLC. Methacholine bronchial challenge was performed and the PD20 was calculated. These results were compared with those obtained from a group of 12 normal children studied in our laboratory. No significant difference was found for pulmonary function parameters studied, except for VisoV which was greater in MAS patients than normals (P less than 0.02). Given the inherent high degree of variability with VisoV, we were not able to ascribe this isolated finding to be indicative of small airway disease in these asymptomatic patients. We conclude that patients with mild to moderate initial insult from MAS show an absence of pulmonary sequelae when tested at an average of 7.4 years of age.