THE OUTCOME OF SURFACTANT THERAPY IN MECONIUM ASPIRATION SYNDROME- A PROSPECTIVE OBSERVATIONAL STUDY IN A TERTIARY CARE HOSPITAL OF BHUBANESWAR

Meconium aspiration syndrome (MAS) remains an important cause of neonatal respiratory distress and contributes significantly to neonatal morbidity and mortality, particularly in term and post-term infants.The aspirated meconium causes airway obstruction, chemical pneumonitis, pulmonary hypertension, and inactivation of endogenous surfactant, resulting in severe respiratory failure.This prospective observational study was conducted in the neonatal intensive care unit of a tertiary care hospital in Bhubaneswar over a period of six months to evaluate the effectiveness of surfactant therapy in neonates with MAS.A total of 60 term neonates (≥37 weeks gestation) born through meconium-stained amniotic fluid who developed respiratory distress requiring respiratory support were enrolled.Surfactant therapy was administered to neonates requiring invasive mechanical ventilation with an oxygen index greater than 10-12.The primary outcomes assessed were mortality and duration of mechanical ventilation.Of the 60 neonates studied, 36 were inborn and 24 were outborn.Forty-eight neonates (80%) were successfully weaned off mechanical ventilation within 48 hours and survived, while 12 neonates (20%) could not be weaned and died.Mortality among neonates who received surfactant therapy was significantly lower (7%) compared to those who did not receive surfactant (42%), with the difference being statistically significant (p ≈ 0.0014).The findings of this study indicate that early administration of surfactant in neonates with meconium aspiration syndrome improves respiratory outcomes, facilitates earlier weaning from ventilatory support, and significantly reduces mortality.