Systematic review of pulmonary surfactant for meconium aspiration syndrome

YANG Tong; SHEN Qi; HUANG Xian-wen

Abstract：Objective To assess the effect and safety of pulmonary surfactant for meconium aspiration syndrome. Meth-ods We searched the data of the Cochrane library、PUBMED、EMBASE、CBMdisc、CNKI、VIP from the time of es-tablishment to 31 December 2008, and assessed the quality of included studies, extracted data and meta-analysis for the result of homogenous studies. Results Eleven studies involving 605 participants were included. Four studies were grad-ed A, the other seven graded C. Meta-analysis based on included studies showed: (1) Pulmonary surfactant vs placebo or no therapy : mortality, pneumothorax, air leaks, chronic lung disease, intraventricular hemorrhage, duration of assisted mechanical ventilation (days) and duration of supplemental oxygen (days) all had no statistically significant difference;duration of hospital stay (days) and treatment with ECMO had statistically significant difference.(2) Pulmonary surfac-tant and mechanical ventilation vs mechanical ventilation: mortality, air leaks, duration of assisted mechanical ventila-tion (days), duration of supplemental oxygen (days), duration of hospital stay (days), OI(12 h、24 h ) and a/A PO2(12 h,24 h) all had statistical significance; intraventricular hemorrhage, OI(0 h) and a/A PO2(O h) had no statistical sig-nificance. Conclusion Available evidence shows: compared with placebo or no therapy, the pulmonary surfactant can' t improve the effect and safety of MAS; compared with mechanical ventilation, pulmonary surfactant and mechanical ven-tilation can improve the effect and safety of MAS; due to the bias, it is necessary to develop the contrast experiment with higher quality and larger scale clinical trials to evaluate its effectiveness and safety.