Intratracheal instillation of budesonide suspension versus normal saline on oxidative stress in neonates with meconium aspiration syndrome

Abstract

Background

Presently, the efficacy of neonatal resuscitation techniques via interventions such as oral, nasal, and endotracheal suction for preventing meconium aspiration syndrome (MAS) after delivery has not been satisfactory.

Objective

This study aimed to investigate the role of intratracheal instillation of budesonide on oxidative stress in MAS.

Methods

Sixty-two neonates with MAS admitted to Huai’an Maternity and Child Healthcare Hospital from January 2018 to June 2020 were divided into a study group (intratracheal instillation of 2 ml budesonide suspension; n = 31) and a control group (intratracheal instillation of 2 ml normal saline; n = 31). Collect data from two groups of patients and evaluate clinical outcomes, including oxygenation index (OI), as well as serum total oxidant status (TOS), total antioxidant capacity (TAC), oxidative stress index (OSI) and 8-Isoprostane before treatment and 72h after admission.

Results

We found no statistical differences in mortality, complication rate, total oxygen inhalation time, OI before treatment and 72h after admission between the two groups of neonates with MAS, while the duration of invasive respiratory support in the study group was significantly shorter than in the control group. Also, serum TAC, TOS, OSI and 8-isoprostane levels were not statistically different before treatment between the two groups. After 72h of admission, OSI and 8-Isoprostane in neonates with MAS in the study group were much lower than those in the control group. TOS, OSI, 8-Isoprostane in the control group and 8-Isoprostane in the study group were significantly higher than those before treatment. As for TAC and TOS, no significant differences were observed between the two groups.

Conclusion

Intratracheal instillation of budesonide was shown to alleviate oxidative stress and shorten invasive ventilation time in neonates with MAS.

Keywords:

• Meconium aspiration syndrome (MAS)
• intratracheal
• budesonide
• oxidative stress
• efficacy
• mortality

Authors’ contributions

Aijuan Qiu and Jing Wang conceptualized and designed the study, Lili Yang and Xiuli Lu, carried out the initial analyses, Wenjie Zhang and Zhaojun Pan drafted the initial manuscript and reviewed and revised the manuscript; and all authors approved the final manuscript as submitted.

Ethics approval and consent to participate

Guardians of all included neonates were informed and signed informed consent forms. Besides, this study was approved by the Ethics Committee of Huai’an Maternity and Child Healthcare Hospital (2017065).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data used to support the findings of this study are available from the corresponding author upon request.

Additional information

Funding

This work was supported by the Jiangsu Maternal and Child Health Research Project (F201746).