Periasamy Uvaraj, Salvador Agnes, Janeczko Michael
Anesthesiology and Critical Care, Boston Children's Hospital, Boston, USA.
Pediatrics and Neonatology, Einstein Medical Center Philadelphia, Philadelphia, USA.
Cureus. 2023 Sep 8;15(9):e44921. doi: 10.7759/cureus.44921. eCollection 2023 Sep.
Objectives To study the pattern of inflammatory markers in meconium aspiration syndrome (MAS) and their correlation with illness severity/antibiotic usage. Study design This is a retrospective analysis of neonates who were admitted with MAS and had inflammatory markers done during the first week of life. Results Seventy-six neonates with MAS were identified. White cell count (WCC), absolute neutrophil count (ANC), and immature to total neutrophil count (I/T) ratio peaked at 12 and CRP (43.75 mg/dl) at 48 hours of life (HOL). Neonates needing nasal cannula oxygen had lower CRP at 12 (p=0.035) and 24 HOL (p=0.046). There was no correlation between CRP at 48 HOL and score for neonatal acute physiology and perinatal extension II (SNAPPE-II; R 0.0004). High CRP at 24 HOL was associated with longer duration of antibiotics (p<0.001) despite no correlation with the blood cultures. Conclusion MAS was associated with inflammatory markers peaking at 12 to 48 HOL; however, antibiotics should not be determined based on them as their correlation for illness severity or blood culture is poor.
目的 研究胎粪吸入综合征（MAS）中炎症标志物的模式及其与疾病严重程度/抗生素使用的相关性。研究设计 这是一项对因MAS入院且在出生后第一周进行了炎症标志物检测的新生儿的回顾性分析。结果 共识别出76例MAS新生儿。白细胞计数（WCC）、绝对中性粒细胞计数（ANC）和未成熟中性粒细胞与总中性粒细胞计数之比（I/T）在出生后12小时达到峰值，而CRP（43.75mg/dl）在出生后48小时达到峰值。需要鼻导管吸氧的新生儿在出生后12小时（p=0.035）和24小时（p=0.046）的CRP较低。出生后48小时的CRP与新生儿急性生理学和围产期延伸II评分（SNAPPE-II；R 0.0004）之间无相关性。尽管与血培养无相关性，但出生后24小时的高CRP与抗生素使用时间延长相关（p<0.001）。结论 MAS与出生后12至48小时达到峰值的炎症标志物相关；然而，不应基于这些标志物来确定是否使用抗生素，因为它们与疾病严重程度或血培养的相关性较差。
