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In order to remove the meconium from the lung as soon as possible , Lam et al. applied broncho-alveolar-lavage (BAL) using diluted surfactant solution (15 ml/kg of saline with 5 mg/ml of surfactant), in 6 infants affected by MAS and necessitating artificial ventilation. Oxygenation index was > 15 within 6 h of life. A large quantity of meconium was removed, due to the detergent effect of diluted surfactant, from the airway by bronchosuctioning. The portion of diluted surfactant that remained in the lung had a more homogeneous distribution which helped to enhance the surfactant system. Oxygenation index, mean airway pressure, FiO2 and a/APO2 ratio improved significantly within the first 48 h. Duration of ventilation and oxygen therapy was also significantly reduced in the treated compared with the control group.
Walsh W, Paranka M. Am J Perinatol 1992
Balaraman V, Sood Sl, Finn KC, Hashiro G, Uyehara CFT, Easa D. Am J Respir Crit Care Med 1996
Lam BCC. Biol Neonate 1999
Lam BCC, Yeung CY. Pediatrics 1999