A term baby with meconium aspiration syndrome is receiving mechanical ventilation per protocol. On the third day, the therapist observes that the FiO₂ requirement is increasing and both lung compliance and oxygenation index are worsening. What should be suggested at this time?

Question

Quizplus · Accepted Answer

The efficacy of surfactant replacement therapy in MAS was first reported in a retrospective study and has been confirmed in several uncontrolled, retrospective studies, four randomized controlled trials, and a meta-analysis. Findlay and co-workers studied 40 term infants receiving mechanical ventilation for MAS and randomized them to either beractant or placebo. They reported that surfactant replacement, started within 6 hours of birth, improves oxygenation, reduces the incidence of air leaks, and reduces the severity of pulmonary morbidity. It also decreased the need for extracorporeal membrane oxygenation (ECMO) from 30% to 5%. Dosing was 6 mL/kg (150 mg) of surfactant, which is slightly higher than used for RDS alone, and surfactant was administered every 6 hours up to four doses.

A Term Baby with Meconium Aspiration Syndrome Is Receiving Mechanical