Peran Bilas Surfaktan pada Neonatus Aterm dengan Sindrom Aspirasi Mekonium
Sari
Latar belakang. Sindrom aspirasi mekonium ditandai dengan gejala distres napas pada neonatus yang lahir dengan cairan amnion terwarna meconium dengan gejala radiologis yang khas. Mekonium dapat menghambat aktivitas dari komponen surfaktan endogen dan dapat menurunkan produksi surfaktan. Pemberian surfaktan secara bolus dapat mengganti surfaktan endogen yang telah ter-inaktivasi oleh asam lemak yang terdapat pada mekonium, sedangkan bilas paru dengan surfaktan dipercaya dapat membuang mekonium yang tersisa di jalan napas.
Tujuan. Mengetahui efektivitas dari bilas surfaktan pada neonatus aterm dengan sindrom aspirasi mekonium
Metode. Penelusuran pustaka database elektronik : Pubmed dan Cochrane
Hasil. Bilas surfaktan dapat menurunkan angka kematian dan penggunaan ECMO dengan RR 0,33 (IK 0,11-0,96). Tidak ada perbedaan yang bermakna dalam hal kejadian pneumotoraks (RR 0,38 IK 0,08-1,90). Bradikardi dan desaturasi dapat ditemukan sebagai efek samping.
Kesimpulan. Bilas surfaktan bermanfaat dalam menurunkan angka kematian pada bayi dengan SAM. Efek samping bilas surfaktan terjadi sementara yaitu hipoksemia dan bradikardi dan dapat kembali normal.
Teks Lengkap:
PDFReferensi
Dargaville PA. Respiratory support in meconium aspiration syndrome : a practical guide. Int J of Ped 2012;1:1-9.
Yeh TF. Meconium aspiration syndrome: pathogenesis and current management. Pediatr Rev 2011;11:e503-11.
Ulah A. Surfactant therapy in meconium aspiration syndrome (MAS). J Obstet Gynecol Barpeta 2014;1:24-9.
Dargaville PA, Copnell B. Australian and new Zealand neonatal network : The epidemiology of meconium aspiration syndrome : Incidence, risk factors, therapies, and outcome. Pediatrics 2006;117:1712-21.
Kosim MS, Infeksi neonatal akibat ketuban keruh. Sari Pediatri 2009;11: 212-8.
Guttentag S, Foster CD. Update in surfactant therapy. Pediatr Rev 2011;11:e 625-33.
Dargaville PA. Innovation in surfactant therapy I : surfactant lavage and surfactant administration by fluid bolus using minimally invasive technique. Neonatology 2012;101:326-36.
Swamam K, Soraisham AS, Sivanandan S. Advances in the management of meconium aspiration syndrome. Int J Pediatr 2012;2012:1-7.
Choi HJ, Hahn S, Lee J, Park B, Lee MS, dkk. Surfactant lavage therapy for meconium aspiration syndrome: a systematic review and meta-analysis. Neonatology 2012;101:183-91.
Wiswell TE, Knight GR, Finner NN, Donn SM. Desai H, dkk. A multicenter randomized controlled trial comparing surfaxin (lucinactant) lavage with standard care for treatment of meconium aspiration syndrome. Pediatrics 2002;109:1081-7.
Dargaville PA, Copnell B, Mills JF, Haron I, Lee JK, dkk. Randomized controlled trial of lung lavage with dilute surfactant for meconium aspiration syndrome. J Pediatr 2011;158:383-89.
Lam BC, Yeung CY. Surfactant lavage for meconium aspiration syndrome: a pilot study. Pediatrics 1999;103:1014-18
Chang HY, Hsu CH, Kao HA, Hung HY, Chang JH, dkk. Tretment of severe meconium aspiration syndrome with dilute surfactant lavage. J Formos Med Assoc 2003;102:326-30. 14. Salvia-Roiges MD, Carbonell-estrany X, Figueras Aloy J, Rodriguez-Miguelez JM: efficacy of three treatment schedules in severe meconium aspiration syndrome. Acta Pediatr 2004;93:60-5.
Dargaville PA, Mills JF, Copnell B, Loughnan PM, McDougall PN, dkk. Therapeutic lung lavage in meconium aspiration syndrome: a preliminary report. J Paediatr Child Health 2007;43:539-45.
Schlosser RL, Veldman A, Fischer D, Allendorf A, von Loewenich V : lavage with exogenous surfactant in neonatal meconium aspiration syndrome. Z Geburtschilfe Neonatol 2002;206:15-8.
Lee SM, Kim HM, Jeon JH, Park MS, Park KI, dkk. Effect of surfactant lavage in severe meconium aspiration syndrome. Korean J Pediatr 2008;51-367-71.
Kowalska K, Szymankiewicz M, Gadzinowski J: an effectiveness of surfactant lung lavage in meconium aspiration syndrome treatment-preliminary report. Przeglad Lekarski 2002;59:21-4.
Kawano T. Effect of surfactant lavage to the babies with meconium aspiration syndrome. Acta Neonatol Jpn 1999;35:32-40.
Hahn S, Choi HJ, Dargaville P. Lung lavage for meconium aspiration syndrome in newborn infants. Coch Database Systematic Review 2013;4:1-31.
Gadzinowski J, Kowalska K, Vidyagasar D. Treatmen of MAS with PPHN using combined therapy: SLL, bolus surfactant and iNO. J Perinatol 2008;28:56-66.
Paschen C, Reite K, Stanzel F, Teschler H, Griese M. Therapeutic lung lavage in children and adults. Respire Res 2005;6:138.
Carson BS, Losey RW, Bowes WAJ, Simmons MA. Combined obstetric and pediatric approach to prevent meconium aspiration syndrome. Am J Obstet Gynecol 1976;126712-5.
Cochrane CG, Revak SD. Meritt TA, Schraufstatter IU, Hoch RC, dkk. Bronchoalveolar lavage with KL4-surfactant in models of meconium aspiration syndrome. Pediatr Res 1998;28:18-23.
Dargaville PA, mills JF, Headley BM, Chan Y, Coleman L. Therapeutic lung lavage in the piglet model of meconium aspiration syndrome. Am J resoir Crit Care Med 2003;168:456-63.
Cleary GM, Antunes MJ, Ciesielka DA, Higins ST, Spitzer AR. Exudative ling injury is associated with decreased levels of surfactant proteins in a rat model of meconium aspirations. Pediatrics 1997;100:998-1003.
Kattwinkel J. Surfactant lavage for meconium aspiration syndrome: aword of caution. Pediatrics 2002;109-1167-8.
DOI: http://dx.doi.org/10.14238/sp19.6.2018.356-63
Refbacks
- Saat ini tidak ada refbacks.
##submission.copyrightStatement##
##submission.license.cc.by-nc-sa4.footer##
Email: editorial [at] saripediatri.org
Sari Pediatri diterbitkan oleh Badan Penerbit Ikatan Dokter Anak Indonesia
Ciptaan disebarluaskan di bawah Lisensi Creative Commons Atribusi-NonKomersial-BerbagiSerupa 4.0 Internasional.