Current significance of meconium plug syndrome

Keckler, Scott J.; Peter, Shawn D. St.; Spilde, Troy L.; Tsao, KuoJen; Ostlie, Daniel J.; Holcomb, George; Snyder, Charles L.

doi:10.1016/j.jpedsurg.2007.12.035

Cited by 72 publications

(22 citation statements)

References 7 publications

(13 reference statements)

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“…Some investigators have linked MPS and CF, reporting an associated incidence with MPS in 24%e43% of patients [7,11]. Other reports have not found any correlation between the two entities and have cited differences in the clinical definition [5]. Although only two of the patients in our cohort were tested using a sweat chloride test for CF, neither test was positive.…”

Section: Discussionmentioning

confidence: 61%

“Pulling the plug”—Management of meconium plug syndrome in neonates

Cuenca

Ali

Kays

et al. 2012

Journal of Surgical Research

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Section: Discussionmentioning

confidence: 61%

“Pulling the plug”—Management of meconium plug syndrome in neonates

Cuenca

Ali

Kays

et al. 2012

Journal of Surgical Research

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“…However, it is important to note that this study was not powered to detect such important adverse effects of the intervention. The role of contrast agents such as barium enema is currently limited to evacuation of the meconium plug in neonates [38,39,40,41]. Cuenca et al [38] have reported a spontaneous resolution of 97% of cases of meconium plug with rectal stimulation or contrast barium enema treatment.…”

Section: Discussionmentioning

confidence: 99%

Meconium Evacuation for Facilitating Feed Tolerance in Preterm Neonates: A Systematic Review and Meta-Analysis

2016

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Background: A delayed passage of meconium is considered as a risk factor for feed intolerance in preterm neonates. Objectives: The aim of this study was to review the effects of different therapeutic agents for meconium evacuation on feed tolerance in preterm neonates. Methods: A systematic review of randomised controlled trials (RCTs) of different therapeutic agents for meconium evacuation in preterm neonates (gestation <32 weeks and/or birth weight <1,500 g) using the Cochrane systematic review methodology was undertaken. Databases including Google Scholar were searched in January 2016. The primary outcome was the time to reach full feeds (TFF; ≥120 ml/kg feeds with stoppage of parenteral nutrition >24 h). Secondary outcomes included necrotising enterocolitis (NEC), weight at discharge and adverse effects. The results were summarised as per the GRADE guidelines. Results: Six RCTs (2 each of glycerine suppository and enema, 1 normal saline enema and 1 oral osmotic contrast agent; n = 442) with a low or unclear risk of bias were included. The pooled estimate (random effects model) showed no reduction in TFF [mean difference (MD) -0.03, 95% CI -2.47, 2.41, p = 0.98; level of evidence: low]. No differences in NEC [risk ratio (RR) 1.71, 95% CI 0.63, 4.65, p = 0.30; level of evidence: low] and weight at discharge (MD -0.08, 95% CI -0.30, 0.15, p = 0.50; level of evidence: low) were found. The trial assessing oral osmotic contrast agents reported a trend towards a higher incidence of NEC ≥ stage II. There were no other adverse effects. Conclusion: Limited low-quality evidence indicates that prophylactic glycerine suppository, small volume glycerine/normal saline enema or oral osmotic contrast agents to evacuate meconium did not reduce TFF in preterm neonates. Large, well-designed trials are essential to study this clinically significant issue.

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“…Neonatal small left colon syndrome is a functional lower intestinal obstruction, distinct from meconium plug syndrome and other causes of neonatal intestinal obstruction [13]. Characteristically, contrast enema is both diagnostic and curative, demonstrating an abrupt transition zone at the splenic flexure and a narrowed left colon and promoting the evacuation of contrast and meconium relieving the intestinal obstruction.…”

Section: Discussionmentioning

confidence: 99%