Lung Lavage with Dilute Surfactant vs. Bolus Surfactant for Meconium Aspiration Syndrome.

OBJECTIVE

To compare the effectiveness of lung lavage with surfactant vs. bolus surfactant treatment in meconium aspiration syndrome (MAS).

PATIENTS AND

METHODS

This randomized controlled trial included newborns ventilated with MAS. In lavage group (n = 17) 30 ml/kg of diluted porcine surfactant was instilled into the lung. In bolus group (n = 16) porcine surfactant (100 mg/kg) was administered as bolus. Respiratory outcomes and mortality were compared between groups.

RESULTS

Duration of respiratory support was found to be similar between lavage and bolus groups (3 vs. 3.5 days, p = 0.36). Death or requirement for extracorporeal membrane oxygenation (ECMO) was 12% vs. 6%; respectively (RR: 2, 95% CI 0.16-24.48; p = 1.0). Duration of oxygen therapy, high-frequency ventilation or inhaled nitric oxide requirement did not differ among the groups.

CONCLUSION

Lung lavage did not show any advantage over bolus therapy on duration of respiratory support. The incidence of pneumothorax and surfactant re-administration decreased nonsignificantly in lavage group.

CLINICAL TRIAL REGISTRATION: We registered the trial to ClinicalTrials.gov (http://clinicaltrials.gov) under identifier NCT02041546.

REGISTRY NAME: Lung Lavage With Dilute Poractant Alfa for Meconium Aspiration Syndrome.