Surfactant therapy for meconium aspiration syndrome in Dr. Soetomo General Hospital – A case series

Introduction: Meconium staining of amniotic fluid (MSAF) is a natural phenomenon in pregnant mothers and their fetuses. MSAF may lead to developing Meconium Aspiration Syndrome (MAS). Surfactant replacement therapy has recently emerged as a therapy in MAS, but no guideline outlines how to administer it properly. Case Presentation: We present two term neonates with severe MAS cases focusing on the bolus surfactant replacement therapy. The first baby was given surfactant at 23 hours after birth and the second baby at 8 hours after birth. We used Survanta (beractant) in the dose of 100 mg/kg BW in both cases. Clinical improvement was observed 24 hours after surfactant bolus administration with different clinical characteristics, treatment approaches, and outcomes.Conclusion: In conclusion, therapeutic surfactant bolus in severe MAS may improve outcomes without significant adverse side effects.

[1]  H. J. Lee,et al.  Inhaled Iloprost as a First-Line Therapy for Persistent Pulmonary Hypertension of the Newborn , 2019 .

[2]  Ga Won Jeon,et al.  Surfactant preparations for preterm infants with respiratory distress syndrome: past, present, and future , 2019, Korean journal of pediatrics.

[3]  S. Nangia,et al.  Meconium aspiration syndrome: challenges and solutions , 2017 .

[4]  V. Paul,et al.  Surfactant therapy and antibiotics in neonates with meconium aspiration syndrome: a systematic review and meta-analysis , 2016, Journal of Perinatology.

[5]  T. Malla,et al.  Meconium Aspiration Syndrome and Neonatal Outcome: A Prospective Study , 2015 .

[6]  Ş. Yiğit,et al.  A retrospective evaluation of term infants treated with surfactant therapy , 2015 .

[7]  T. Mollnes,et al.  Meconium Aspiration Syndrome: Possible Pathophysiological Mechanisms and Future Potential Therapies , 2015, Neonatology.

[8]  P. Dargaville,et al.  Surfactant for meconium aspiration syndrome in term and late preterm infants. , 2014, The Cochrane database of systematic reviews.

[9]  S. Lakshminrusimha,et al.  Update on PPHN: mechanisms and treatment. , 2014, Seminars in perinatology.

[10]  A. Soraisham,et al.  Advances in the Management of Meconium Aspiration Syndrome , 2011, International journal of pediatrics.

[11]  P. Dargaville,et al.  Surfactant Therapy for Meconium Aspiration Syndrome , 2012, Drugs.

[12]  T. Yeh Core Concepts : Meconium Aspiration Syndrome : Pathogenesis and Current Management , 2010 .

[13]  P. Dargaville,et al.  Surfactant for meconium aspiration syndrome in full term/near term infants. , 2007, The Cochrane database of systematic reviews.