pulmicort and Pneumonia--Aspiration

Meconium aspiration syndrome (MAS) is one of the major causes of severe respiratory distress in the newborn and there is no uniform protocol of management after the development of MAS.. The objective of the study was to determine whether systemic and inhalational steroid therapy can alter the clinical course of MAS and improve the outcome without causing any serious adverse effects.. A randomized controlled trial was conducted in three groups of MAS over a period of 1 year. Group A (n = 33) served as controls, Group B (n = 34) received systemic methyl prednisolone and Group C (n = 32) received nebulized budesonide both for a period of 7 days starting after 24 h of age. Details of clinical progress were noted during the hospital stay. Follow up for a minimum period of 3 months was done in all. Data were analysed by SPSS 10 software. Student's t and ANOVA were used to assess statistical significance.. Patient profile was similar in all the three groups. Period of oxygen dependency and duration of hospital stay was significantly less in the steroid treated groups. Similarly full enteral feeding and radiological clearance of chest could be achieved earlier in groups B and C. No difference between the steroid treated groups could be appreciated by Student's Newman Kuel (SNK) test. Development of sepsis was similar in all the groups and no serious adverse effects were noted in steroid treated groups.. Steroids are effective in the management of MAS and route of administration does not have a bearing on the efficacy.

Topics: Administration, Inhalation; Analysis of Variance; Anti-Inflammatory Agents; Budesonide; Female; Humans; Infant, Newborn; Male; Meconium Aspiration Syndrome; Methylprednisolone; Pneumonia, Aspiration; Respiratory Distress Syndrome, Newborn

Local administration of corticosteroids may diminish acute lung injury associated with meconium aspiration. Budesonide was given intratracheally in 2 doses of 0.25 mg/kg each by means of inpulsion effect of high-frequency jet ventilation 0.5 and 2.5 hours after meconium instillation to oxygen-ventilated adult rabbits. Within 5 hours after the first dose, budesonide significantly improved gas exchange and decreased right-to-left pulmonary shunts, central venous pressure, and ventilatory pressures. In addition, budesonide reduced the meconium-induced lung edema formation, airway hyperreactivity to histamine, count of neutrophils in bronchoalveolar lavage fluid associated with higher total white blood cell and neutrophil counts in the blood, and diminished oxidative modifications of proteins and lipids in lung tissue compared to non-treated meconium-instilled group. The intratracheally administered corticosteroid budesonide effectively improved pulmonary functions and alleviated changes associated with inflammation in meconium-instilled rabbits.

Topics: Adrenal Cortex Hormones; Animals; Bronchial Provocation Tests; Bronchoconstriction; Bronchoconstrictor Agents; Budesonide; Central Venous Pressure; Disease Models, Animal; Histamine; Humans; Infant, Newborn; Intubation, Intratracheal; Lipid Peroxidation; Lung; Meconium Aspiration Syndrome; Neutrophil Infiltration; Oxidative Stress; Pneumonia, Aspiration; Protein Carbonylation; Pulmonary Circulation; Pulmonary Edema; Pulmonary Gas Exchange; Pulmonary Ventilation; Rabbits; Respiratory System Agents