Pulmonary sequelae of meconium aspiration

American Family Physician,  Dec, 1989  

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Meconium aspiration syndrome occurs mostly in full-term infants, who often require assisted mechanical ventilation and oxygen. To determine the long-term effects of meconium aspiration syndrome, Swaminathan and colleagues studied pulmonary function in a group of children who had been treated for this disease.

The medical records of neonates with meconium aspiration syndrome who were born during a four-year period were reviewed. All of the infants had respiratory failure because of meconium aspiration, demonstrated atelectasis and hyperinflation of the lungs on chest radiographs, and required either assisted mechanical ventilation or oxygen. Of the 75 patients identified, 11 could be contacted. Although this group was representative of the entire population, three children were excluded because of mental retardation from birth asphyxia. The mean age of the children was 8.1 + 0.4 years. None of these children were considered by their parents to have serious pulmonary problems. Nine healthy children born at term constituted the control group (mean age: 8.0 + 0.4 years).

Following resting pulmonary function tests, each child performed a graded exercise test on a treadmill. The protocol for increasing work load was designed to ensure that exercise would last between eight and 12 minutes and that maximal oxygen consumption would be attained.

The children with a history of meconium aspiration syndrome had evidence of mild airway obstruction, hyperinflation and increased closing volumes. During graded exercise tests, the children with meconium aspiration syndrome achieved normal maximal oxygen consumption and anaerobic threshold without a significant fall in arterial oxygen saturation or an increase in CO, tension. Exercise-induced bronchospasm occurred in four (36 percent) of the children with a history of meconium aspiration syndrome but in none of the control subjects.

The authors conclude that children surviving meconium aspiration syndrome have long-term pulmonary sequelae, including airway obstruction, hyperinflation, elevated closing volumes and airway hyperactivity. However, they can achieve normal aerobic capacity. Journal of Pediatrics, March 1989, vol. 114, p. 356.)

COPYRIGHT 1989 American Academy of Family Physicians
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