Meconium Aspiration Syndrome

A condition caused by inhalation of MECONIUM into the LUNG of FETUS or NEWBORN, usually due to vigorous respiratory movements during difficult PARTURITION or respiratory system abnormalities. Meconium aspirate may block small airways leading to difficulties in PULMONARY GAS EXCHANGE and ASPIRATION PNEUMONIA.

Also Known As:

Aspiration, Meconium; Meconium Aspiration; Meconium Inhalation; Aspiration Syndrome, Meconium; Syndrome, Meconium Aspiration

Networked: 616 relevant articles (49 outcomes, 68 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Pneumonia (Pneumonitis)
2.	Sepsis (Septicemia)
3.	Respiratory Insufficiency (Respiratory Failure)
4.	Pulmonary Hypertension
5.	Hemorrhage

Experts

1.	Cahill, Alison G: 11 articles (01/2022 - 10/2014)
2.	Calkovska, Andrea: 11 articles (03/2019 - 10/2004)
3.	Mokra, Daniela: 11 articles (03/2019 - 01/2006)
4.	Lakshminrusimha, Satyan: 10 articles (07/2021 - 01/2015)
5.	Calkovska, A: 10 articles (02/2016 - 01/2003)
6.	Mokra, D: 10 articles (02/2016 - 01/2005)
7.	Macones, George A: 9 articles (01/2021 - 10/2014)
8.	Dargaville, Peter A: 9 articles (12/2014 - 08/2003)
9.	Jeng, Mei-Jy: 8 articles (01/2020 - 04/2006)
10.	Raghuraman, Nandini: 7 articles (01/2022 - 01/2017)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Meconium Aspiration Syndrome:

1.	Surface-Active Agents (Surfactants)IBA 10/01/2004 - "Combination of surfactant lavage with both CV and AHFJV was beneficial in rabbits with meconium aspiration syndrome. " 05/01/2008 - "Surfactant treatment has been tried in a number of other neonatal respiratory disorders but only infants with meconium aspiration seem to benefit although larger and more frequent doses are probably needed to demonstrate improved lung function. " 02/01/2002 - "These results suggest that continuous infusion of exogenous surfactant is more effective than bolus administration in improving pulmonary function after meconium aspiration." 01/01/2021 - "Surfactant for meconium aspiration was not associated with improved neonatal outcomes. " 01/01/2004 - "Animal models of meconium aspiration treated with surfactant have improved histology, lung mechanics and gas exchange. "
2.	Nitric Oxide (Nitrogen Monoxide)FDA Link 10/01/2000 - "In this model of meconium aspiration syndrome, short-term exposure to inhaled nitric oxide when combined with high-frequency oscillatory ventilation improved oxygenation secondary to better distribution of inhaled nitric oxide. " 10/01/1999 - "To investigate the possible protective effects of nitric oxide (NO) inhalation in newborns with meconium aspiration, 18 10-12-d-old piglets were studied for 6h after an intratracheal bolus (3 ml/kg) of a 65-mg/ml mixture of human meconium. " 03/01/2008 - "[A randomized controlled study on the efficacy of inhaled nitric oxide in treatment of neonates with meconium aspiration syndrome]." 02/01/2007 - "Inhaled nitric oxide treatment inhibits neuronal injury after meconium aspiration in piglets." 10/01/2000 - "To test the hypothesis that inhaled nitric oxide, when combined with high-frequency oscillatory ventilation, is an effective therapeutic agent in meconium aspiration syndrome. "
3.	Oxygen (Dioxygen)IBA 01/01/2019 - "Partial arterial pressure of oxygen/fraction of oxygen in inspired air (PaO2/FiO2) ratio has been used as a predictor of outcome in some neonatal conditions, but has not been used in meconium aspiration syndrome (MAS). " 09/01/2017 - "Meconium aspiration syndrome (MAS) is defined by respiratory distress requiring supplemental oxygen in a meconium-stained neonate. " 01/01/2016 - "Total periods of oxygen supplementation of the infants with aRD were significantly longer than those of infants with TTN, but shorter than those of the infants with meconium aspiration syndrome (MAS). " 09/01/2001 - "Newborn piglets with meconium aspiration resuscitated with room air or 100% oxygen." 10/01/2000 - "Arterial saturation and partial pressure of arterial oxygen (Pao2) were significantly lower after meconium aspiration when compared with baseline. "
4.	AlbuminsIBA 03/01/2005 - "Rescue treatment with albumin in meconium aspiration improved lung compliance in piglets and may represent a new therapeutic approach to MAS." 03/01/2005 - "The aim of this study was to test the effect of albumin instillation as rescue treatment in meconium aspiration syndrome (MAS). " 12/01/2008 - "To review and summarize experimental data examining the effects of different fractions of meconium, and to test the effect of albumin on meconium aspiration both as prophylactic and rescue treatment. " 10/01/2008 - "Albumin-lavage did not improve the outcome of experimental meconium aspiration syndrome." 10/01/2008 - "Our group has previously shown reduced oxygenation index in an experimental model of meconium aspiration syndrome in newborn pigs when mixing albumin with meconium before endotracheal instillation. "
5.	Hydrocortisone (Cortisol)FDA LinkGeneric 01/01/1977 - "Hydrocortisone therapy in meconium aspiration syndrome: a controlled study." 01/01/2021 - "In infants with meconium aspiration syndrome, hydrocortisone was associated with decreased oxygen at discharge (odds ratio 0.56; 95% confidence interval 0.21, 0.91). " 03/01/1975 - "Because of this decreased survival and the relatively insignificant improvement in clinical course and histopathology found with glucocorticoid treatment, we cannot recommend cortisol for the treatment of meconium aspiration." 01/01/2019 - "Hydrocortisone has been shown to decrease oxygen dependency and pulmonary hypertension in neonates with meconium aspiration syndrome and animal studies, respectively. " 01/01/1977 - "To evaluate the efficacy of glucocorticoids in the treatment of infants with meconium aspiration syndrome, a double-blind study using hydrocortisone or a lactose placebo was undertaken. "
6.	Dexamethasone (Maxidex)FDA LinkGeneric 02/01/2009 - "Because cardiovascular functions and their control mechanisms may be influenced by meconium aspiration and by treatment, cardiovascular parameters including heart rate variability (HRV) were evaluated after meconium instillation and treatment with dexamethasone. " 02/01/2001 - "These results show that prophylactic dexamethasone treatment significantly attenuates the early pulmonary hemodynamic deterioration and structural lung damage caused by meconium aspiration. " 08/01/1999 - "We examined the effects of dexamethasone on lung function in a piglet model of meconium aspiration syndrome. " 08/01/1999 - "Effects of dexamethasone on meconium aspiration syndrome in newborn piglets." 09/01/1995 - "Dexamethasone in meconium aspiration."
7.	GlucocorticoidsIBA 03/01/1975 - "An animal model of meconium aspiration was developed to determine the efficacy of glucocorticoids in its treatment. " 12/01/2011 - "Glucocorticoids in the treatment of neonatal meconium aspiration syndrome." 11/01/2008 - "Glucocorticoids may improve lung function in newborns with meconium aspiration syndrome (MAS), but information on the acute side effects of glucocorticoids in infants is limited. " 03/01/1975 - "Experimental meconium aspiration: Effects of glucocorticoid treatment." 06/01/2010 - "[Research advance in glucocorticoids therapy for meconium aspiration syndrome]."
8.	Pulmonary Surfactants (Pulmonary Surfactant)IBA 01/01/2015 - "The aim of this study was to investigate the clinical efficiency of the use high-frequency oscillatory ventilation (HFOV) combined with pulmonary surfactant (PS) for the treatment of neonatal meconium aspiration syndrome (MAS). " 01/01/2000 - "Searches were made using Medline (1985 to January 2000) (MeSH terms: pulmonary surfactant and meconium aspiration; limits: age groups, newborns; publication type, clinical trials), previous reviews including cross-references, abstracts, conference and symposia proceedings, expert informants, and journal hand searching in the English language. " 11/27/2022 - "The inflammatory processes caused by meconium aspiration in animal models will be analyzed, and the cellular apoptosis and biochemical processes of pulmonary surfactant inactivation will be discussed." 01/01/2015 - "Efficiency of high-frequency oscillatory ventilation combined with pulmonary surfactant in the treatment of neonatal meconium aspiration syndrome." 07/01/2014 - "To evaluate the clinical effect of endotracheal lavage with porcine pulmonary surfactant (PS) in term neonates with severe meconium aspiration syndrome (MAS). "
9.	SteroidsIBA 01/01/2003 - "Randomised controlled trials and quasi-randomised trials comparing steroid treatment to no steroid treatment for neonates with meconium aspiration syndrome were considered for this review. " 11/21/2021 - "The Effects of Different Types of Steroids on Clinical Outcomes in Neonates with Meconium Aspiration Syndrome: A Systematic Review, Meta-Analysis and GRADE Assessment." 01/01/2021 - "Steroids for the Management of Neonates With Meconium Aspiration Syndrome: A Systematic Review and Meta-analysis." 04/01/2007 - "To determine the levels of TNFa and IL-1beta in tracheal aspirates of neonates with meconium aspiration syndrome (MAS) and to ascertain whether the use of steroids by systemic or nebulized routes suppresses the levels of these inflammatory markers. " 02/01/2007 - "The conclusion is that steroids alter the course of Meconium Aspiration Syndrome and favorably affect the outcome."
10.	Budesonide (Pulmicort)FDA LinkGeneric 01/01/2016 - "The role of early inhaled budesonide therapy in meconium aspiration in term newborns: a randomized control study." 01/01/2016 - "Budesonide nebulization in meconium aspiration results in significant early improvement in general condition (early improvement in respiratory distress and early normalization of Downe's score) of the newborn with lesser oxygen requirement, thus early discharge from NICU but has no impact on final outcome." 12/22/2016 - "Lung inflammatory and oxidative alterations after exogenous surfactant therapy fortified with budesonide in rabbit model of meconium aspiration syndrome." 12/01/2008 - "Combination of budesonide and aminophylline diminished acute lung injury in animal model of meconium aspiration syndrome." 01/01/2016 - "To study the clinical spectrum of Meconium aspiration syndrome babies and to find out the efficacy of early nebulized steroids (Budesonide) in the clinical course and outcome (morbidity and mortality) of neonates with meconium aspiration: randomized controlled trial. "

Therapies and Procedures

1.	Therapeutics 01/01/2015 - "Meconium aspiration syndrome: possible pathophysiological mechanisms and future potential therapies." 05/01/2006 - "The epidemiology of meconium aspiration syndrome: incidence, risk factors, therapies, and outcome." 05/01/2003 - "Despite the development of new adjuvant therapies, meconium aspiration syndrome (MAS) remains a serious respiratory disorder in neonates. " 03/01/2001 - "Over the past decade, several new therapies have been suggested to be more effective than "conventional" management in treating meconium aspiration syndrome. " 03/01/2001 - "In many affected children, the complex nature of meconium aspiration syndrome contributes to the apparent lack of response to standard therapies. "
2.	Extracorporeal Membrane Oxygenation 01/01/2003 - "This questionnaire study was designed to determine how consultant paediatricians perceived the value of extracorporeal membrane oxygenation (ECMO) in the treatment of meconium aspiration syndrome (MAS). " 01/01/2020 - "Extracorporeal membrane oxygenation was first successfully achieved in 1975 in a neonate with meconium aspiration. " 01/01/2019 - "We aim to evaluate clinical outcomes of emergent extracorporeal membrane oxygenation (ECMO) implantation in newborns with life-threatening meconium aspiration syndrome (MAS) in peripheral hospitals with Hub and Spoke (HandS) setting. " 01/01/2018 - "After reviewing a case, comparative outcome data, and relevant ethical principles, we propose that extracorporeal membrane oxygenation for meconium aspiration syndrome may, in some cases, be an ethically obligatory treatment." 11/01/2017 - "Among these, 51 of 98 (52%) had meconium aspiration syndrome, and 74 of 98 (75%) were on veno-arterial extracorporeal membrane oxygenation with a median (interquartile range) duration of 6 days (4-8 d). "
3.	High-Frequency Jet Ventilation 01/01/2003 - "To determine the efficacy of the expulsion effect of high-frequency jet ventilation (HFJV) on meconium clearance from the airways in comparison with conventional suctioning in adult rabbits with meconium aspiration. " 01/01/2003 - "Lung lavage using high-frequency jet ventilation in rabbits with meconium aspiration." 01/01/1988 - "Lung pathology after high frequency jet ventilation combined with low rate intermittent mandatory ventilation in a canine model of meconium aspiration." 01/01/1986 - "Combined high-frequency jet ventilation in a meconium aspiration model." 07/01/1985 - "Conventional vs high-frequency jet ventilation in a piglet model of meconium aspiration: comparison of pulmonary and hemodynamic effects."
4.	Aftercare (After-Treatment) 06/01/1992 - "To determine whether abnormalities in lung mechanics detected in infants during the acute phase of meconium aspiration syndrome persist after treatment with extracorporeal membrane oxygenation (EMCO). " 03/01/2017 - "In the group of patients who survived the first 90 days after treatment, the 10-year survival rates were 93% in neonates and 89% in pediatric patients and were particularly beneficial in patients whose indication for extracorporeal membrane oxygenation was meconium aspiration syndrome, trauma, or infectious diseases. " 09/01/1996 - "We studied ventilation efficiency after treatment with a modified porcine surfactant in experimental meconium aspiration. " 10/01/1997 - "In this model of meconium aspiration syndrome, short-term exposure to inhaled nitric oxide after treatment with surfactant improved oxygenation secondary to better distribution of inhaled nitric oxide. " 10/01/1997 - "Effect of nitric oxide in meconium aspiration syndrome after treatment with surfactant."
5.	Resuscitation 01/01/2021 - "Clearance of meconium from the airways below the vocal cords by tracheal suction before initiating other steps of resuscitation may reduce the risk of development of MAS. However, conducting tracheal suction may not only be ineffective, it may also delay effective resuscitation, thus prolonging and worsening the hypoxic-ischaemic insult. OBJECTIVES: To evaluate the efficacy of tracheal suctioning at birth in preventing meconium aspiration syndrome and other complications among non-vigorous neonates born through meconium-stained amniotic fluid. " 12/30/2022 - " This study aimed to evaluate the effect of the 2015 Neonatal Resuscitation Program recommendations of no routine endotracheal suctioning for nonvigorous neonates on the incidence of meconium aspiration syndrome (MAS) and death. " 01/01/2022 - "Before 2015, major changes in Neonatal Resuscitation Program (NRP) recommendations not supporting previously endorsed antepartum, intrapartum and postpartum interventions to prevent meconium aspiration syndrome were based on adequately powered multicenter randomized controlled trials. " 01/01/2020 - "To describe trends in the incidence and severity of meconium aspiration syndrome (MAS) around the release of revised Neonatal Resuscitation Program (NRP) guidelines in 2016. " 01/01/2020 - "Change in neonatal resuscitation guidelines and trends in incidence of meconium aspiration syndrome in California."