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Meconium Aspiration Syndrome (Clinical signs and symptoms (Tachypnea >…
Meconium Aspiration Syndrome
Etiology
Fetal hypoxemia and stress
Causes a vagal response that relaxes anal sphincter and allows meconium to move into the amniotic fluid
HIGH-RISK
Post-term infants
Breech position
Infants with mothers that are toxemic, hypertensive or obese
Pathophysiology
Fetal breathing movement
Moves pulmonary fetal fluid into and out of the oropharynx with the glottis remains closed
During fetal hypoxemia
Fetus may demonstrate very deep, gasping inspiratory movements that may force the contest of the nasooropharynx to pass through the glottis into the airways
Chemical pneumonitis
Acute inflammatory reaction
Edema of the bronchial mucosa and alveolar epithelium
Excessive bronchia secretions
Alveolar consolidation
Meconium promotes growth of bacteria which can lead to alveolar pneumonitis, infection and consolidation
Partial airway obstruction
Air trapping
Alveolar hyperinflation
Pulmonary air leak syndrome (pneumomediastinum or pneumothorax)
Total airway obstruction and absorption atelectasis
Diagnostic testing
CXR
Alveolar atelectasis
Consolidation
Partial airway obstruction
Air trapping
Alveolar hyperinflation
Depressed diaphragm
Differential diagnosis
Pneumonia is commonly confused with meconium aspiration syndrome
Respiratory management
Emergently suction oropharynx
Intubated
Use laryngoscope
Tracheal suction using MECONIUM ASPIRATOR
PPV
Bronchial hygiene and PRN sx
Oxygen therapy
Lung expansion therapy
Clinical signs and symptoms
Tachypnea >60 bpm
Increased HR and BP
Intercostal retractions
Substernal retractions
Cyanosis
Flaring nostrils
BS: Wheezing and crackles
Expiratory grunting
Meconium stained (brownish-yellow color) on skin, nails,umbilical cord, wrinkles and creases of skin
Barrel chest