Effect Of Nebulized Budesonide In Improving The Clinical Outcome Of Neonates With Meconium Aspiration Syndrome
Aim and Objective: To study the effect of nebulized steroid in improving the clinical outcome in terms of morbidity and mortality in neonates with meconium aspiration syndrome.
Design: Prospective open labeled randomized controlled trial.
Setting: Tertiary care teaching hospital.
Patients: Full term babies with diagnosis of meconium aspiration syndrome(MAS) admitted in the NICU of Cheluvamba Hospital attached to Mysore Medical College and Research Institute were included in the study.
Intervention: Administration of nebulized budesonide in a dose of 50µg in 2.5ml normal saline through jet nebulizer every 12hourly from second day of life till 7days or clinical recovery whichever is earlier.
Results: A Total of 60 patients with diagnosis of MAS were admitted to the NICU during the period of August - October 2013,out of them 20 were excluded,so a total of 40 patients were included in the study,20 in control group(Group A),20 in budesonide group (Group B). The baseline clinical profile of both the groups were similar.Duration of respiratory distress in days (2.63 vs 5.24 p=0.0493), duration of oxygen dependency (2.37 vs 4.94 p=0.0406), duration of hospital stay (7.58 vs 10.47 p=0.0430), time taken for achievement of full feeds (3.79 vs 8.76 p=0.0002) and the need for mechanical ventilation (0 vs 0.2 p=0.0356) were statistically less in budesonide treated group as compared to the controls.Incidence of sepsis is similar in both the groups. Complications were similar in both the groups and no specific adverse effects were noted in the steroid treated group. Four patients died during the hospital stay,three in the control group and one in the case group .Out of them two patients died due to pneumothorax and both of them belong to the control group,other two patients died due to sepsis with disseminated intravascular coagulation(DIC), representing one each from control and case group.
Conclusion: Nebulized budesonide improves the clinical outcome in terms of morbidity and is relatively safe,however long term follow-up is needed to recommend inhalation route of steroids as safe and effective.
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