Meconium aspiration syndrome
Summary
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- signs of postmaturity
- tachypnea
- cyanosis
- chest wall asymmetry with decreased air entry
- barrel-shaped chest
Другие диагностические факторы
- grunting
- chest retractions
- rales
- rhonchi
- tachycardia
- hypotension
Факторы риска
- gestational age >42 weeks
- pregnancy-induced hypertension
- maternal diabetes mellitus
- maternal smoking or substance misuse
- fetal distress
- oligohydramnios
- thick meconium
- Apgar score <7
- chorioamnionitis
- cesarean delivery
- black ancestry
- male sex
Диагностические исследования
Исследования, которые показаны в первую очередь
- CXR
- CBC
- CRP
- blood culture
Исследования, проведение которых нужно рассмотреть
- dual pulse oximetry
- ABG (pH, PaO₂, PaCO₂)
- echocardiography
- cranial ultrasound
- electroencephalogram
- urinalysis
Алгоритм лечения
vigorous infant born through meconium-stained amniotic fluid, no respiratory distress
mild MAS
moderate MAS
severe MAS
Составители
Авторы
Dharmapuri Vidyasagar, MD, MSc, FAAP, FCCM, PhD (Hon)
Professor Emeritus
Department of Pediatrics
University of Illinois at Chicago
Chicago
IL
Visiting Professor
Department of Neonatology
Sri Ramachandra Medical College
Chennai
India
Раскрытие информации
DV is an author of a number of references cited in this topic. He has received royalties for editing the following books: Neonatal Ventilation (Elsevier India), Practical Neonatology (Indian Journal of Pediatrics), and Perinatal Cardiology (Cambridge Scholar publishing).
Rama Bhat, MD, FAAP
Professor of Pediatrics
Department of Pediatrics
University of Illinois at Chicago
Chicago
IL
Раскрытие информации
RB is an author of a reference cited in this topic.
Рецензенты
Ahmed Osman, MD
Assistant Professor of Pediatrics
Attending Neonatologist
Department of Pediatrics
The Ohio State University and Nationwide Children’s Hospital
Columbus
OH
Раскрытие информации
AO is an author of a reference cited in this topic.
Henry L. Halliday, MD, FRCPE, FRCP, FRCPCH
Professor
Retired Consultant Neonatologist
Royal Maternity Hospital
Honorary Professor
Department of Child Health
Queen's University Belfast
Belfast
UK
Раскрытие информации
HLH declares that he has no competing interests.
John Sinn, MBBS(Syd), Dip Paed, DCH, MMed (Clin Epi), FRACP (Paed)
Clinical Senior Lecturer
Obstetrics
Gynaecology and Neonatology
Royal North Shore Hospital and The University of Sydney
Sydney
Australia
Раскрытие информации
JS declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
Thornton PD, Campbell RT, Mogos MF, et al. Meconium aspiration syndrome: incidence and outcomes using discharge data. Early Hum Dev. 2019 Sep;136:21-6. Аннотация
Singh BS, Clark RH, Powers RJ, et al. Meconium aspiration syndrome remains a significant problem in the NICU: outcomes and treatment patterns in term neonates admitted for intensive care during a ten-year period. J Perinatol. 2009 Jul;29(7):497-503. Аннотация
Vidyasagar D, Harris V, Pildes RS. Assisted ventilation in infants with meconium aspiration syndrome. Pediatrics. 1975 Aug;56(2):208-13. Аннотация
Wiswell TE, Gannon CM, Jacob J, et al. Delivery room management of the apparently vigorous meconium-stained neonate: results of the multicenter, international collaborative trial. Pediatrics. 2000 Jan;105(1 Pt 1):1-7. Аннотация
Yamada NK, Szyld E, Strand ML, et al. 2023 American Heart Association and American Academy of Pediatrics focused update on neonatal resuscitation: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2024 Jan 2;149(1):e157-66.Полный текст Аннотация
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Transient tachypnea of the newborn
- Surfactant deficiency
- Persistent pulmonary hypertension
Больше ОтличияGuidelines
- 2023 American Heart Association and American Academy of Pediatrics focused update on neonatal resuscitation: An update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care
- Management of meconium at birth
Больше Guidelines
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