Surfactant lung lavage therapy in reducing assisted ventilation period and mortality in neonates with meconium aspiration syndrome

Abstract

Overview: Meconium aspiration syndrome is a disease characterised by neonatal respiratory distress caused by aspiration of meconium-stained amniotic fluid before, during or after birth. Surfactant lung lavage is a type of therapy in which a diluted solution of surfactant is administered into the lungs and the resulting mixture of surfactant, meconium-stained amniotic fluid and other resulting constituents including blood and mucus are suctioned out to help the neonate breathe better with the surfactant given. Research question: Does surfactant lung lavage therapy reduce assisted ventilation period and mortality in neonates with meconium aspiration syndrome? PICO elements: The population (P) studied was neonates with meconium aspiration syndrome. The intervention (I) observed was surfactant lung lavage. The comparison was standard care(C) .The final desired Outcome (O) was reducing assisted ventilation time and mortality. Method: The key elements of the PICO question were used as key terms to generate alternative terms. These terms were combined using the Boolean Operators. Limiters were used to bring down the search results. The Combined terms were searched in two databases; EBSCO and PubMed. The PRISMA 2009 checklist was used to eliminate irrelevant articles. The inclusion/exclusion criteria were applied to assess the eligibility of the articles. The Critical Appraisal Skills Programme (CASP) tool was used to critically appraise the literature. Results: A total of six key studies were identified. These included four systematic reviews/metaanalysis and two randomised control trials. Not all these studies were consistent however, the majority found some degree of reduction in the exposure group in both outcomes. Conclusion: More extensive research is needed to find a conclusive answer however, most of the available research points to a benefit from performing surfactant lung lavage therapy in neonates suffering from meconium aspiration syndrome. Also, all the studies found that the therapy is safe to be performed on neonates since physiological changes were not noted. Implications and recommendations: From the results found, one can note that this type of therapy can be beneficial in reducing assisted ventilation time. More extensive research needs to be conducted in order to have a clearer picture of the effect of surfactant lung lavage on aspiration meconium syndrome.