Olicker Arielle L, Raffay Thomas M, Ryan Rita M
Department of Pediatrics, Case Western Reserve University, UH Rainbow Babies & Children's Hospital, 11100 Euclid Ave, Cleveland, OH 44106, USA.
Children (Basel). 2021 Mar 23;8(3):246. doi: 10.3390/children8030246.
Infants born through meconium-stained amniotic fluid (MSAF) are 100 times more likely than infants born through clear amniotic fluid to develop respiratory distress in the neonatal period. Meconium aspiration syndrome (MAS) is a common cause of respiratory distress in term and post-mature neonates. MAS is defined as respiratory distress accompanied by a supplemental oxygen requirement in an infant born with MSAF, in the absence of any other identified etiology to explain the symptoms. Therapy for MAS is supportive, and should be tailored to each infant's specific pathophysiology. In cases of MAS with severe persistent pulmonary hypertension of the newborn (PPHN), patients may remain hypoxic despite aggressive ventilation, and in these cases surfactant, inhaled nitric oxide (iNO) and extracorporeal membrane oxygenation (ECMO) can be life-saving. Long-term prognosis for MAS is more related to severity of initial hypoxemia and possible neurological insult than to the pulmonary pathology.
通过胎粪污染羊水（MSAF）出生的婴儿在新生儿期发生呼吸窘迫的可能性是通过清澈羊水出生的婴儿的100倍。胎粪吸入综合征（MAS）是足月儿和过期产儿呼吸窘迫的常见原因。MAS定义为在出生时伴有MSAF且无其他明确病因解释症状的婴儿中，伴有补充氧气需求的呼吸窘迫。MAS的治疗是支持性的，应根据每个婴儿的具体病理生理情况进行调整。在患有严重持续性新生儿肺动脉高压（PPHN）的MAS病例中，尽管进行了积极的通气，患者可能仍会缺氧，在这些情况下，表面活性剂、吸入一氧化氮（iNO）和体外膜肺氧合（ECMO）可能会挽救生命。MAS的长期预后与初始低氧血症的严重程度和可能的神经损伤比与肺部病理情况的关系更大。
