Meconium Aspiration syndrome

[Mohan]

What are the present recommendations on use of surfactant in MAS? What is the upper age limit till when it can be used? 

[Stefan Johansson]

You can always start with the latest Cochrane reviews

http://www.ncbi.nlm.nih.gov/pubmed/17636695

http://www.ncbi.nlm.nih.gov/pubmed/23633311

 

Just my personal experience - know where you have chest tubings. As you know - pneumothorax is common in MAS and my personal experience is that the risk if higher in those needing surfactant. Probably more due to disease severity and probably less due to the surfactant itself.

[juan carlos vidal]

Hello everyone, I would like to know what you think of this case
a patient with meconium aspiration syndrome, which developed pulmonary hypertension. It is found in high frequency with a draguer v500. 4000g weight
with the following setting, 6hz 16 map 80fio2 deltap 50, dco2 800,
with good oxygenation but persistence of hypercapnia. what allowed me to download fio2 and map but not the rest.
What strategy would you use?

[Stefan Johansson]

@juan carlos vidal sorry that I did not see that you posted this question in this thread - but have shared over our social channels now.

Anyway, it seems that you have adjusted the HFV as possible, with reduced freq and a higher d-P. Does your ventilator give tidal volumes? What approx levels of PCO2 (kPa) do you have? Have you tested regular tidal support, like SIPPV?

 

[juan carlos vidal]

 

Hi . the patient is already better. the problem was that it should lower the frequency to the maximum and return to high values of delta p. I think the problem is the draguer vn500 that is not powerful enough to ventilate a patient of 4500 gs by passing it to the sle500 put down the pco2