Effect of nebulized budesonide in improving the clinical outcome of neonates with meconium aspiration syndrome.

Abstract

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. Patients: Full term babies with clinical 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(Budecort,Cipla) 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: 40 patients were randomized into 20 in control group(Group-A) and 20 in budesonide group(Group-B). The baseline clinical profile of both the groups were similar. Duration of respiratory distress in days (2.63vs5.24 p=0.0493), duration of oxygen dependency(2.37vs4.94 p=0.0406), duration of hospital stay(7.58vs10.47 p=0.0430), time taken for achievement of full feeds(3.79vs8.76 p=0.0002) and the need for mechanical ventilation(0vs0.2 p=0.0356) were statistically less in budesonide treated group as compared to the controls. Complications were similar in both the groups. 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 short term respiratory outcome and is relatively safe, however long term follow-up is needed to recommend inhalation route of steroids as safe and effective.