Study on effects of steroid on clinical course, short-term and long-term outcomes in neonates with meconium aspiration syndrome

Rana, Kriti Sundar; Konar, Mithun Chandra; Islam, Kamirul; Barik, Kanai Lal; Nayek, Kaustav; Datta, Anuja

doi:10.1016/j.jnn.2018.06.001

Cited by 3 publications

(11 citation statements)

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“…PS drugs are synthetic preparations, which can effectively compensate for the related diseases of the body's lack of lung surfactant, improve the alveolar surface tension and lung ventilation, and improve the compliance of the lung. Its application effect in the treatment of MAS has been affirmed by multiple studies [15,16]. Ambroxol hydrochloride (Mucosolvan) is also one of the treatment drugs for MAS, which can quickly promote sputum excretion and promote lung maturation and can accelerate the synthesis and secretion of PS by stimulating the development of alveolar type II cells.…”

Section: Discussionmentioning

confidence: 99%

Machine Learning Algorithm-Based Analysis of Efficacy of Pulmonary Surfactant Combined with Mucosolvan in Meconium Aspiration Syndrome of Newborns through Ultrasonic Images

Ji¹,

Lou

Ji³

2021

Scientific Programming

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Objective. The study aimed to explore the efficacy of pulmonary surfactant (PS) combined with Mucosolvan in the diagnosis of meconium aspiration syndrome (MAS) in newborns through ultrasonic images of lung based on machine learning. Methods. 138 cases of infants with MAS were selected as the research subjects and randomly divided into PS group (n = 46), Mucosolvan group (n = 46), and combination group (n = 46). Then, ultrasonic images based on machine learning algorithm were used for examination. On the basis of conventional treatment, the PS group accepted intratracheal PS drip treatment with 100 mg/kg. For the Mucosolvan group, 7.5 mg/kg of Mucosolvan was added with 50 g/L glucose, which was diluted to 3 mL. Then, the mixture was injected intravenously with a micropump for more than 5 min. The combination group received combined treatment of PS and Mucosolvan. If there was no relief or the symptoms aggravated after 12 h of PS treatment, the patient should be treated again. 7.5 mg/kg/d of Mucosolvan was given for 7 days. Mechanical ventilation time, hospitalization time, oxygenation index (OI) before treatment, at 3 d and at 7 d after treatment, and arterial/alveolar oxygen ratio (a/APO2) of the three groups were detected and compared. Besides, in-hospital mortality and complication rate of the three groups were statistically compared. Results. Ultrasonic image edge detection based on machine learning algorithm was more condensed and better than Sobel operator. Compared with the PS group and the Mucosolvan group, treatment efficiency, OI at 3 d and at 7 d after treatment, and a/APO2 of combination group were increased. Mechanical ventilation time and hospitalization time of the combination group were shortened, and mortality rate of the combination group was reduced ( P < 0.05). Compared with the situation before treatment, OI at 3 d and at 7 d after treatment and a/APO2 of the combination group were increased, and OI at 7 d after treatment and a/APO2 of the PS group and the Mucosolvan group were increased ( P < 0.05). Curative effect, mechanical ventilation time, hospitalization time, OI before and after treatment, a/APO2, and mortality rate during hospitalization of the PS group and the Mucosolvan group had no significant difference ( P > 0.05). There was no significant difference in the complications rates in the three groups ( P > 0.05). Conclusion. Pulmonary ultrasound based on machine learning algorithm can be used in the diagnosis of MAS in neonates. PS combined with Mucosolvan is feasible and safe in treating neonatal MAS and effectively improves the pulmonary oxygenation function. Therefore, it is worthy of clinical application.

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Section: Discussionmentioning

confidence: 99%

Machine Learning Algorithm-Based Analysis of Efficacy of Pulmonary Surfactant Combined with Mucosolvan in Meconium Aspiration Syndrome of Newborns through Ultrasonic Images

Ji¹,

Lou

Ji³

2021

Scientific Programming

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“…Eleven studies met our inclusion criteria, but the full text of Davey et al [27] was not assessed. Finally, 10 studies [28][29][30][31][32][33][34][35][36][37] were included in our systematic review, 7 of which [29][30][31][32][33]35,36] were included in the meta-analysis. No additional articles were retrieved from the reference lists of the included studies.…”

Section: Search Strategy and Selection Criteriamentioning

confidence: 99%

“…Two studies compared nebulized NSS versus nebulized budesonide [32,33]. One study assigned patients to receive either nebulized 3% sodium chloride with IV NSS (placebo) or nebulized budesonide with IV methylprednisolone [37]. One study [34], patients received intratracheal instillation of porcine lung surfactant (PS) or intratracheal instillation of PS with budesonide.…”

Section: Data Extraction and Risk-of-bias Assessment Study Characteristicsmentioning

confidence: 99%

“…MAS [28][29][30][31][32][33][34]36,37] • Delivery of MSAF infants and retrieval of meconium from below the larynx on endotracheal tube suction; Positive C-reactive protein.…”

Section: Data Extraction and Risk-of-bias Assessment Study Characteristicsmentioning

confidence: 99%

“…The allocation sequence was generated in 5 of 10 the studies [28,[30][31][32][33], 1 of which used concealed allocation [30]. Three studies were double-blind RCTs [28,29,31] Loss to followup [28][29][30][31][32][33][34][35][36][37] and selective outcome reporting were adequate.…”

Section: Risk-of-bias Assessmentmentioning

confidence: 99%

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The Effects of Different Types of Steroids on Clinical Outcomes in Neonates with Meconium Aspiration Syndrome: A Systematic Review, Meta-Analysis and GRADE Assessment

2021

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Background and Objectives: Meconium aspiration syndrome (MAS) is a condition caused by the aspiration of meconium-stainted amniotic fluid into the lungs, resulting in pulmonary inflammation, neonatal morbidity, and mortality. It is important that these MAS infants receive appropriate care to avoid further complications. Steroids have an anti-inflammatory effect and may be effective in the management of MAS. The objective of the this study was to evaluate the effect of different steroids on clinical outcomes in infants with MAS. Materials and Methods: We systematically searched of PubMed/Medline, Scopus, Embase, Clinical Trials.gov, and Cochrane Library databases from inception to 24 January 2021 without language restriction. Only randomized controlled trials (RCTs) evaluating the effects of steroids in neonates with MAS were included. We calculated relative risks and weighted mean differences (MDs) with 95% confidence intervals (CIs) using a random-effects model to determine the associations between MAS and steroids and GRADE approach was employed for quality of evidence. The main outcomes measures were duration of respiratory distress, oxygen requirement, hospitalization, need for mechanical ventilation, death, and adverse drug reactions. Results: Seven RCTs involving 397 patients were analyzed. Nebulized budesonide and intravenous (IV) methylprednisolone shortened the duration of respiratory distress (MD, −2.46 days; 95% CI, −3.09 to −1.83 and MD, −3.30 days; 95% CI, −4.07 to −2.52, respectively) (moderate certainty). There was a reduction in duration of oxygen requirement in nebulized budesonide use (MD, −2.40 days; 95% CI, −3.40 to −1.40) (low certainty) and IV methylprednisolone use (MD, −3.30 days; 95% CI, −4.07 to −2.52) (moderate certainty). Nebulized budesonide shortened hospitalization stay (MD, −4.47 days; 95% CI, −8.64 to −0.30 days) (low certainty) as IV methylprednisolone use (MD, −7.23 days; 95% CI, −8.19 to −6.07 days) (moderate certainty). None of steroids benefits in death (low certainty). Conclusions: Certain types of steroids may benefit the respiratory aspect, but there was no decrease in mortality in MAS infants.

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Steroids for the Management of Neonates With Meconium Aspiration Syndrome: A Systematic Review and Meta-analysis

2021

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Study on effects of steroid on clinical course, short-term and long-term outcomes in neonates with meconium aspiration syndrome

Cited by 3 publications

References 19 publications

Machine Learning Algorithm-Based Analysis of Efficacy of Pulmonary Surfactant Combined with Mucosolvan in Meconium Aspiration Syndrome of Newborns through Ultrasonic Images

Machine Learning Algorithm-Based Analysis of Efficacy of Pulmonary Surfactant Combined with Mucosolvan in Meconium Aspiration Syndrome of Newborns through Ultrasonic Images

The Effects of Different Types of Steroids on Clinical Outcomes in Neonates with Meconium Aspiration Syndrome: A Systematic Review, Meta-Analysis and GRADE Assessment

Steroids for the Management of Neonates With Meconium Aspiration Syndrome: A Systematic Review and Meta-analysis

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