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Surfactant lavage for neonatal meconium aspiration syndrome-An updated meta-analysis

Rong Hui1, Pan Jing-Jing2, Zou Yun-Su1

  • 1Department of Neonates, Children's Hospital of Nanjing Medical University, Nanjing, China.

Journal of the Chinese Medical Association : JCMA
|August 12, 2020
PubMed
Abstract

Insights

Surfactant lavage improves oxygenation and reduces mechanical ventilation days for meconium aspiration syndrome (MAS). This treatment does not increase complications but does not shorten hospital stays or oxygen therapy duration.

Area of Science:

  • Neonatal Medicine
  • Respiratory Medicine
  • Pediatric Critical Care

Background:

  • Meconium aspiration syndrome (MAS) poses significant risks to newborns.
  • Surfactant lavage shows promise in treating MAS, but its efficacy and safety remain debated.
  • Existing data on surfactant lavage for MAS complications are conflicting, necessitating updated analysis.

Purpose of the Study:

  • To conduct a meta-analysis evaluating the effectiveness of surfactant lavage in managing MAS.
  • To assess the impact of surfactant lavage on pulmonary complications and clinical outcomes in MAS patients.
  • To provide an updated evidence-based summary of surfactant lavage's role in MAS treatment.

Main Methods:

  • Comprehensive literature search across PubMed, Embase, Cochrane, Wanfang, VIP, and Cnki databases.
  • Inclusion of 11 original studies comparing surfactant lavage (n=189) with control groups (n=204).
  • Statistical analysis using random or fixed effects models to calculate odds ratios and weighted mean differences.

Main Results:

  • Surfactant lavage significantly improved oxygen index at 48 and 72 hours (WMD = -3.37, p=0.004; WMD = -2.70, p<0.00001).
  • Mechanical ventilation duration was significantly reduced with surfactant lavage (WMD = -1.12, p<0.00001).
  • No significant differences were observed in extracorporeal membrane oxygenation, oxygen therapy duration, hospital stay, mortality, persistent pulmonary hypertension, or pulmonary hemorrhage. Pneumothorax risk was reduced (OR = 0.46, p=0.01).

Conclusions:

  • Surfactant lavage is effective in improving oxygenation and reducing mechanical ventilation duration in MAS.
  • The treatment does not appear to increase the risk of serious complications like pneumothorax.
  • While beneficial for key respiratory markers, surfactant lavage did not significantly shorten overall oxygen therapy or hospital stay.

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