[Meconium aspiration syndrome. Determination of a prognostic index]

A study was undertaken on 54 cases of meconial aspiration in order to establish a prognostic index allowing the early estimation of the risk of occurrence of refractory hypoxia. In order to do so, the factors statistically related to the occurrence of refractory hypoxia were taken into account. These factors consisted of the first arterial blood gas determination, first chest x-ray film and the initial Silverman index. A value was assigned to each parameter, with respect to the corresponding percentage of observed refractory hypoxias. The sum of the values determined the prognostic index, which varied from 6 to 25. For a high-risk threshold fixed at 15, sensibility was 78%, specificity 90% and the predictive value 84%. For an index between 16 and 20, 70% of patients developed refractory hypoxia. Occurrence was 100% for an index above 20 and refractory hypoxia occurred early. On the contrary with indexes between 6 and 14, occurrence was 15%. The calculation of this index might help clinicians in their therapeutic decisions.