الفهرس 
Commonly Associated Findings with MASOnly 14 pages are availabe for public view
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Abstract
Meconium is the infant’s earliest stools, which consist of materials released by the intestines or swallowed by the fetus. MSAF occurs when the fetus defecates prior to delivery.
The use of steroids in MAS has not been extensively investigated. Whatever budesonide is an anti-inflammatory corticosteroid that exhibits potent glucocorticoid activity and weak mineralocorticoid activity. Budesonide shows approximately a 200-fold higher affinity for the glucocorticoid receptor and a 1000-fold higher topical anti-inflammatory potency than cortisol
We aimed to study the effect of inhaled budesonide therapy in full term neonates with Meconium Aspiration Syndrome.
This cross-sectional study was conducted on 100 cases of full term neonates with meconium aspiration syndrome in the NICU of El_Bagour hospital and Menoufia university hospital over a period of 5 months (September 2019 – January 2020) after taking written informed consents from the parents after explanation the aim of the study.
The neonates divided into two groups: group A (Case group): 50 full term neonates with meconium aspiration syndrome received budesonide nebulization (0.5 mg dissolved in 2.5-ml sterile normal saline within 2 hrs after birth and second dose was given at 12 hrs after birth).
group B (Control group): 50-control cases full term neonates with meconium aspiration syndrome received normal saline nebulization. (2.5-ml sterile normal saline within 2 hrs after birth and second dose was given at 12 hrs after birth).
Full term babies with the diagnosis of MAS (Meconium Aspiration Syndrome) according to the criteria: Presence of meconium from below the larynx on endotracheal suction, Respiratory distress development within 4 hour after birth and persistence beyond 24 hours, Presence of infiltrations, hyperinflation and atelectasis in Chest x-r, Exclusion of any other cause of respiratory distress.
Full history taking and full clinical examination were done. Laboratory examination: CBC (complete blood count), C-reactive protein, Chest X-ray, Capillary Blood Gas (CBG) and Follow up CBC, CRP to detect late onset sepsis.
Our results relieved that:
There were no statistically significant difference between both groups regarding demographic data. There were no statistically significant difference between budesonide and saline groups regarding APGAR 1min and 5min.
On Comparison between budesonide and Saline groups regarding general examination before nebulization, there were no statistically significant difference between budesonide and saline groups regarding conscious level, color, activity, reflexes perfusion and edema.
Summary
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On Comparison between budesonide and Saline groups regarding general examination after nebulization, there were statistically significant difference in budesonide rather than saline groups regarding activity, reflexes and perfusion. There were no statistically significant difference between budesonide and saline groups regarding conscious level, color and edema.
There were no statistically significant difference between budesonide and saline groups regarding Hb, Hct, WBC, PLT and CRP at day 2 of life. There were no statistically significant difference between budesonide and saline groups regarding PH, PCO2, PO2, HCO3 and O2 saturation (SO2) nebulization.
There was no statistically significant difference between budesonide and saline groups regarding complication except for fate. There was significant increase in mortality (28% compared to 8%) and decrease in discharged cases (68% compared to 88%) in saline group compared to budesonide group. Regarding NICU stay, there was significant increase in saline group compared to budesonide group (14.02+5.85 compared to 10.11+3.57).
There were no statistically significant difference between budesonide and saline groups regarding need O2 support, sepsis, PPHN, secondary pneumonia and pleural effusion. There was statistically significant increase in saline group compared to budesonide group regarding O2 duration, air leak and mortality.
There were statistically positive significant correlation between NICU stay duration, O2 duration, respiratory distress grade pre nebulizer, air leak and days to reach full feed in both groups, while there were significant negative correlation between NICU duration and score of APGAR 5 minutes.
We concluded that:
Budesonide can alter the course of meconium aspiration syndrome and favorably affect the outcome, In addition, is relatively safe.
We recommended that:
Early introduction of inhaled budesonide in MAS due to its role in early improvement in clinical condition