System-based Strategy on the Management of Meconium Aspiration Syndrome: Consecutive 198 cases Observation

中國醫藥大學機構典藏 China Medical University Repository, Taiwan > 中醫學院 > 中醫學系暨碩博班 > 期刊論文 > Item 310903500/4070

jsp.display-item.identifier=請使用永久網址來引用或連結此文件: http://ir.cmu.edu.tw/ir/handle/310903500/4070

题名:	System-based Strategy on the Management of Meconium Aspiration Syndrome: Consecutive 198 cases Observation
作者:	林鴻志(Hung-Chih Lin);蘇百弘(Bai-Horng Su);林宗文;蔡長海(Chang-Hai Tsai)
贡献者:	中醫學院中醫學系學士班中醫內科學科
日期:	2005
上传时间:	2009-08-20 19:28:33 (UTC+8)
摘要:	To evaluate whether the system-based strategy for management of meconium aspiration syndrome (MAS) could reduce the morbidity and mortality rate of MAS in our institute, a prospective consecutive clinical observation was conducted. System-based strategy including appropriately trained the relevant medical staff to familiar with neonatal resuscitation program, early surfactant replacement or lavage following with high-frequency ventilator (HFV) and/or inhaled nitric oxide (iNO). Outcome measurements were the morbidity and mortality rates of MAS. All infants of MAS in the study period were included except cases of congenital malformations or cyanotic congenital heart disease (CHD). Oxygen, nasal continuous positive airway pressure (CPAP), and intermittent mandatory ventilation (IMV) were applied as clinically indicated. Surfactant was used as replacement or lavage therapy for MAS infants whose oxygen index (OI) exceeded 20 or value for AaDO2 exceeded 400 within 6 hours of age. High-frequency oscillator ventilation (HFO) was applied for infants of MAS that demonstrated intractable respiratory failure with conventional mechanical ventilation and 100% oxygen. Inhaled nitric oxide (iNO) was used with IMV or HFO for infants of persistent pulmonary hypertension (PPHN) when it was unresponsive to conventional therapy. Dexamethasone was prescribed in infants of severe hypotension that did not respond to dopamine and epinephrine. A series of 198 consecutive infants of MAS born in this hospital during 9 years were analyzed. There was no mortality. Fourteen infants developed PPHN, 11 had pneumothorax, 1 had pulmonary hemorrhage, 2 had neurologic sequelae because of severe asphyxia, and 2 developed bronchopulmonary dysplasia. Our results indicated that appropriately trained relevant medical staff with neonatal resuscitation program to avoid complicated MAS and early surfactant replacement or lavage following with HFO and/or iNO could reduce the morbidity and mortality rate of MAS even without extracorporeal membrane oxygenation (ECMO).
關聯:	Acta Paediatrica Taiwanica46(2):67~71
显示于类别:	[中醫學系暨碩博班] 期刊論文

文件中的档案:

档案	大小	格式	浏览次数
	0Kb	Unknown	316	检视/开启

在CMUR中所有的数据项都受到原著作权保护.

TAIR相关文章

数据加载中.....