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Outcomes of severe meconium aspiration syndrome in a resource restricted hospital, Cape Town, South Africa
Thesis (MMed) -- Stellenbosch University, 2022.
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Stellenbosch : Stellenbosch University
2022
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| _version_ | 1867614134860775424 |
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| access_status_str | Open Access |
| author | Busgeeth, Mohammad Asrafee Jameel |
| author2 | Van Wyk, Lizelle |
| author_browse | Busgeeth, Mohammad Asrafee Jameel Van Wyk, Lizelle |
| author_facet | Van Wyk, Lizelle Busgeeth, Mohammad Asrafee Jameel |
| author_sort | Busgeeth, Mohammad Asrafee Jameel |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MMed) -- Stellenbosch University, 2022. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/126159 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:47:13.037Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/126159 Outcomes of severe meconium aspiration syndrome in a resource restricted hospital, Cape Town, South Africa Busgeeth, Mohammad Asrafee Jameel Van Wyk, Lizelle Goussard, Pierre Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health. Meconium aspiration syndrome Respiratory distress syndrome Neonatology -- Cape Town UCTD Thesis (MMed) -- Stellenbosch University, 2022. ENGLISH ABSTRACT: Background/Aim: Meconium aspiration syndrome (MAS) is defined as respiratory distress in a neonate born through meconium-stained amniotic fluid (MSAF) whose symptoms cannot be otherwise explained. Mortality and morbidities vary in different resourced health settings. This study aimed to describe the management strategies, short-term (in-hospital) outcomes and mortality of neonates with severe MAS (defined as those requiring invasive ventilation) at a resource restricted hospital in Cape Town, South Africa. Methodology: We performed a retrospective descriptive study of neonates requiring invasive ventilation for suspected MAS at Tygerberg hospital, Cape Town, South Africa between January 2016, and December 2018. Results: Ninety-two neonates with suspected MAS were included in the initial cohort, of which only 47 qualified based on the radiological findings (patchy infiltrates and hyperinflation), as diagnosed by consensus between a neonatologist and pediatric pulmonologist. The cohort had a mean gestational age of 39.7±1.4 weeks and mean birth weight of 3246±522g. Most babies were born outside Tygerberg hospital. High frequency oscillation was the most common initial mode of ventilation (55%). The median duration of invasive ventilation was 3 (IQR 2-4.5) days and total duration of respiratory support was a median of 9 (IQR 4-16) days. Surfactant was administered in 70% of neonates. Fifty-three percent of neonates developed pulmonary hypertension (PPHN) of which 88% received inhaled nitric oxide. Inotropes were required by 45% of neonates and steroids were administered in 64%. The incidence of pneumothorax on initial CXR was 9%. Neonates were discharged from NICU at a median age of 5 (IQR 3-7) days and had a hospital stay of 12 ( IQR 6-21) days. Overall mortality was 8.5%. Conclusion: This is the first study showing outcomes and mortality of MAS at Tygerberg Hospital. Mortality was low and is lower than resource restricted countries but remains higher than high resource countries. Similarly, complications associated with severe MAS, such as PPHN and pneumothorax, were also lower than in other resource restricted countries but higher than in high resource countries. Definitions for PPHN, choice of inotropes and steroids were variable and may have influenced various outcomes. This needs further investigation in future prospective studies. AFRIKAANS OPSOMMING: Agtergrond: Mekonium-aspirasie-sindroom (MAS) word gedefinieer as respiratoriese nood in 'n neonaat wat gebore word deur mekonium-gekleurde vrugwater (MSAF) wie se simptome nie anders verklaar kan word nie. Mortaliteit en morbiditeite van MAS verskil tussen lande van verskillende gesondheidshulpbronne Die bestuurstrategieë, korttermyn (binne-hospitaal) uitkomste en mortaliteit van neonate met MAS by Tygerberg Hospitaal is nie beskryf nie Metodologie: Ons het tussen Januarie 2016 tot Desember 2018 'n retrospektiewe beskrywende studie van neonate wat indringende ventilasie benodig vir vermoedelike MAS by Tygerberg-hospitaal, Kaapstad, Suid-Afrika uitgevoer. Resultate: Twee-en-negentig neonate met vermoedelike MAS is in die aanvanklike kohort ingesluit, waarvan slegs 47 gekwalifiseer het op grond van die radiologiese bevindinge, soos gediagnoseer deur 'n neonatoloog en pediatriese pulmonoloog. Die groep het 'n gemiddelde swangerskapsouderdom van 39±1.4 weke en 'n gemiddelde geboortegewig van 3260±522g gehad. Meeste babas was buite Tygerberg-hospitaal gebore. Hoëfrekwensie-ossillasie was die mees algemene aanvanklike ventilasiemodus (55%). Die gemiddelde duur van indringende ventilasie was 3 (IQR 2-4.5) dae en totale respiratoriese duur was 9 (IQR 4-16) dae. Surfaktant was in 70% van neonate toegedien. Pulmonale hipertensie (PPHN) het in 53% van babas ontwikkel waarvan 88% ingeasemde stikstofoksied ontvang het. Inotrope is deur 45% van neonate benodig en steroïede is in 64%. Die voorkoms van pneumothorax op die aanvanklike borskas x-straal was 9%. Neonate is op 'n gemiddelde ouderdom van 5 (IQR 3-7) dae uit NICU ontslaan en het 'n gemiddelde hospitaalverblyf van 12 ( IQR 6-21) dae gehad. Mortaliteit was 8.5 %. Gevolgtrekking: Hierdie is die eerste studie wat uitkomste en mortaliteit van MAS by Tygerberg Hospitaal beskryf. Mortaliteit was laag en is laer as ander beperkte mediese hulpbron lande maar hoër as hoër hulpbron lande. Gepaardgaande siektes wat met MAS geassosieer word, insluitend PPHN en pneumothoraks, blyk ook laer te wees as ander beperkte mediese hulpbron lande maar hoër as hoër hulpbron lande. Definisies vir PPHN, keuse van inotroop en keuse van steroïde was veranderlik en kon verskeie uitkomste beïnvloed het. Dit verg verdere navorsing in toekomstige prospektiewe studies. Masters 2022-11-21T16:55:44Z 2023-01-16T12:53:07Z 2022-11-21T16:55:44Z 2023-01-16T12:53:07Z 2022-11 Thesis http://hdl.handle.net/10019.1/126159 en_ZA Stellenbosch University 31 pages application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Meconium aspiration syndrome Respiratory distress syndrome Neonatology -- Cape Town UCTD Busgeeth, Mohammad Asrafee Jameel Outcomes of severe meconium aspiration syndrome in a resource restricted hospital, Cape Town, South Africa |
| title | Outcomes of severe meconium aspiration syndrome in a resource restricted hospital, Cape Town, South Africa |
| title_full | Outcomes of severe meconium aspiration syndrome in a resource restricted hospital, Cape Town, South Africa |
| title_fullStr | Outcomes of severe meconium aspiration syndrome in a resource restricted hospital, Cape Town, South Africa |
| title_full_unstemmed | Outcomes of severe meconium aspiration syndrome in a resource restricted hospital, Cape Town, South Africa |
| title_short | Outcomes of severe meconium aspiration syndrome in a resource restricted hospital, Cape Town, South Africa |
| title_sort | outcomes of severe meconium aspiration syndrome in a resource restricted hospital cape town south africa |
| topic | Meconium aspiration syndrome Respiratory distress syndrome Neonatology -- Cape Town UCTD |
| url | http://hdl.handle.net/10019.1/126159 |
| work_keys_str_mv | AT busgeethmohammadasrafeejameel outcomesofseveremeconiumaspirationsyndromeinaresourcerestrictedhospitalcapetownsouthafrica |