Relation Between Inflammatory Indices and The Outcome of Meconium Aspiration Syndrome

doi:10.21608/smj.2018.35856

Relation Between Inflammatory Indices and The Outcome of Meconium Aspiration Syndrome

Document Type : Original Article

10.21608/smj.2018.35856

Abstract

Background: Meconium aspiration syndrome (MAS) is linked to inflammation,but data on the patterns of hematologica indices and C-reactive protein (CRP) in MAS are lacking The aim of the study was to evaluate CRP, white blood cell count (WBC), absolute neutrophil count (ANC), and procalcitonin in MASandtoassesstheirassociationwithdiseaseseverity.
Methods: a prospective hospital based studyincluding 200 babies admitted in this period with MSAF, among those 50 babies have meconium aspiration syndrome (25 males). Recruited neonates were 1-7 days old with range of weight from 2 to 3.9kg
Results: all the inflammatory indices were markedly elevated in cases of MAS with septicemia in comparison with cases of MAS without septicemia, maximum CRP, and maximum PCT values were higher in neonates with very sever and sever MAS compared to non sever MAS. PCT and CRP correlated with duration of mechanical ventilation , duration of any respiratory support and length of hospital stay. PCT more sensitive rather than other inflammatory indices.

Keywords

References

1-Ahanya SN, Sureshbabu N, Morgan BL, Ross MG, Meconium passage in utero: mechanisms, consequences and management. ObstetGynecolSurv. 2005;60(1):45-65.

2- Altunhan H, Annagür A, Örs R et al, Procalcitonin measurement at 24 hours of age may be helpful in the prompt diagnosis of early-onset neonatal sepsis. Int. J. Infect. Dis. 2011; 15: e854–858.

3-Angert RM ,Pilon AL, Chester D, Reduces inflammation in meconium aspiration syndrome. Ann Trop Paediatr 2007;27:107-13.

4- Ameta G, Upadhyay A, Gothwal S, Singh K, Dubey K, Gupta A, Role of gastric lavage in vigorous neonates born with meconium stained amniotic fluid. Indian J Pediatr. 2013;80(3):195–198.

5- Amro K, Usefulness of C-reactive protein in diagnosis of intrapartum and postpartum neonatal sepsis. Sudan Journal of Medical Sciences 2008;3 :233-238.

6-Balchin I, Whittaker JC, Lamont RF, Steer PJ, Maternal and fetal characteristics associated with meconium-stained amniotic fluid. Obstet Gynecol. 2011: 117(4):828-35.

7- Baquero H, Soliz A, Neira F, Venegas ME, Sola A, Oral sildenafil in infants with persistent pulmonary hypertension of the newborn: a pilot randomized blinde study. Pediatrics 2006; 117: 1077–1083.

8-Barratt-Due A, Pischke SE, Brekke OL, Thorgersen EB, Nielsen EW, Espevik T, Huber-Lang M, Mollnes TE, Bride and groom in systemic inflammation - the bells ring for complement and Toll in cooperation. Immunobiology 2012;217:1047-1056.

9-Basu B, Sinha SK ,Basu T ,Mahapatra TK, Factors predicting mortality in newborn ventilation .pediatrpulmonol 2015:50:271.

10- Basu S, Kumar A, Bhatia BD. Role of antibiotics in meconium aspiration syndrome . Ann Trop Pediatr 2007;27:107-13.

11-Becker KL, Snider R, Nylen ES, Procalcitonin assay in systemic inflammation, infection, and sepsis: Clinical utility and limitations. Crit Care Med. 2008;36:941–952.

12 -Benitz WE., Adjunct laboratory tests in the diagnosis of early-onset neonatal sepsis. Clin. Perinatol. 2010; 37: 421–438.

13-Bergamini CM, Gambetti S, Dondi A, Cervellati C, Oxygen, reactive oxygen species and tissue damage. Curr Pharm Des 2004;10:1611-1626.

14-Bouadma L, Luyt CE, Tubach F et al , Use of procalcitonin to reduce patients' exposure to antibiotics in intensive care units (PRORATA trial): A multicentrerandomised controlled trial. Lancet 2010; 375: 463–474.

15-Brown KL,Striam S, Ridout D, CassidyJ, Pandya H, Liddell M, Davis C, Goldman A, Field D , Karimova A , Extracorporeal membrane oxygenation and term neonatal respiratory failure deaths in the United Kingdom compared with the United States:1999-2005. PediatrCrit Care Med 2010:11:60-65.

16 -Carbine DN, Meconium aspiration .Paediatr Rev2008;29:212-3.16

17-Castellheim A, Pharo A, Fung M, Saugstad OD, Mollnes TE, Complement C5a is a key mediator of meconium-induced neutrophil activation. Pediatr Res 2005;57:242-247.

18- Cayabyab RG, Kwong K, Jones C, Minoo P, Durand M, Lung inflammation and pulmonary function in infant in infants with meconium aspiration. Pediatrpulmonol 2007;42:898-905.

19-Chacko B, Sohi I, Early onset neonatal sepsis . Indian J Pediatr 2005;72:23-26.

20-Chettri S, Adhisivam B, Bhat BV, Endotracheal suction for non vigorous neonates born through meconium stained amniotic fluid: a randomized controlled trial. J Pediatr. 2015;166(5):1208–1213.

21-Chiesa C, Natale F, Pascone R, et al, C reactive protein and procalcitonin; reference intervals for preterm and term newborns during the early neonatal period.ClinChimActa. 2011;412(11-12):1053-1059.

22-Chiesa C, Pellegrini G, Panero A, Osborn JF, Signore F, Assumma M, et al, C-reactive protein, interleukin-6, and procalcitonin in the immediate postnatal period: influence of illness severity, risk status, antenatal and perinatal complications, and infection. Clinical Chemistry. 2003;49(1):60-8.

23- Christensen, R. D., Henry, e., Jopling, J., &Wiedmeier, S. E, The CBC: Reference ranges for neonates. Pediatr Res. 2009:33,,3–11.

24-Dargaville PA, Respiratory support in meconium aspiration syndrome: A practical guide. Int J Pediatr. 2012;2012:965159.

25-Dargaville PA, Copnell B, The epidemiology of meconium aspiration syndrome: incidence, risk factors therapies, and outcome. Pediatrics 2006: 117: 1712-1721.