akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2024.533akusherstvo-2114Research ArticleCLINICAL CASEКЛИНИЧЕСКИЙ СЛУЧАЙSurfactant lung lavage in neonatal meconium aspiration syndrome as a life-saving respiratory strategy: literature review and a case reportЛаваж легких сурфактантом при неонатальном синдроме аспирации мекония как жизнеспасающая респираторная стратегия: обзор литературы и клинический случайhttps://orcid.org/0000-0002-7040-9683МостовойА. В.MostovoiA. V.

Мостовой Алексей Валерьевич - к.м.н.

123423 Москва, ул. Саляма Адиля, д. 2/44; 123995 Москва, ул. Баррикадная, д. 2/1, корп. 1; 150000 Ярославль, ул. Революционная, д. 5

Scopus Author ID 57201723894; Wos ResearcherID AAR-7908-2021

Aleksei V. Mostovoi - MD, PhD.

2/44 Salyama Adilya Str., Moscow 123423; 2/1 bldg. 1, Barrikadnaya Str., Moscow 123993; 5 Revolutsionnaya Str., Yaroslavl 150000

Scopus Author ID 57201723894; Wos ResearcherID AAR-7908-2021

valmost@mail.ruhttps://orcid.org/0000-0002-1024-0230КарповаА. Л.KarpovaA. L.

Карпова Анна Львовна - к.м.н.

123423 Москва, ул. Саляма Адиля, д. 2/44; 123995 Москва, ул. Баррикадная, д. 2/1, корп. 1; 150000 Ярославль, ул. Революционная, д. 5

Anna L. Karpova - MD, PhD.

2/44 Salyama Adilya Str., Moscow 123423; 2/1 bldg. 1, Barrikadnaya Str., Moscow 123993; 5 Revolutsionnaya Str., Yaroslavl 150000

https://orcid.org/0000-0002-0530-2310ПоповИ. В.PopovI. V.

Попов Игорь Владимирович.

123423 Москва, ул. Саляма Адиля, д. 2/44

Wos ResearcherID F-7040-2016

Igor V. Popov - MD.

2/44 Salyama Adilya Str., Moscow 123423

Wos ResearcherID F-7040-2016

https://orcid.org/0009-0001-0210-4669АникееваЛ. А.AnikeevaL. A.

Аникеева Любовь Алексеевна.

123423 Москва, ул. Саляма Адиля, д. 2/44

Lubov’ A. Anikeeva - MD.

2/44 Salyama Adilya Str., Moscow 123423

https://orcid.org/0000-0001-6728-726XКарповН. Ю.KarpovN. Yu.

Карпов Николай Юрьевич.

152303 Тутаев, ул. Комсомольская, д. 104

Nikolai Yu. Karpov - MD.

104 Komsomolskaya Str., Tutaev, Yaroslavl Region 152303

ГБУЗ «Городская клиническая больница № 67 имени Л.А. Ворохобова Департамента здравоохранения города Москвы»; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации; ФГБОУ ВО «Ярославский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияVorokhobov City Clinical Hospital № 67, Moscow Healthcare Department; Russian Medical Academy of Continuous Professional Education, Health Ministry of Russian Federation; Yaroslavl State Medical University, Health Ministry of Russian FederationRussian FederationГБУЗ «Городская клиническая больница № 67 имени Л.А. Ворохобова Департамента здравоохранения города Москвы»РоссияVorokhobov City Clinical Hospital № 67, Moscow Healthcare DepartmentRussian FederationГБУЗ Ярославской области «Тутаевская центральная районная больница»РоссияTutaev Central District HospitalRussian Federation202423072024184581595Copyright © Mostovoi A.V., Karpova A.L., Popov I.V., Anikeeva L.A., Karpov N.Y., 20242024Мостовой А.В., Карпова А.Л., Попов И.В., Аникеева Л.А., Карпов Н.Ю.Mostovoi A.V., Karpova A.L., Popov I.V., Anikeeva L.A., Karpov N.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/2114

Here, we review the latest available studies on using surfactant lavage in newborns with severe manifestations of meconium aspiration syndrome (MAS), illustrated by a representative clinical case. Meconium-stained amniotic fluid may be found in 8-20 % of all births, with the incidence reaching 23-52 % after a full 42 weeks of gestation. From 2 to 9 % of newborns with meconium-stained amniotic fluid subsequently develop MAS clinical signs. About a third of newborns with MAS require tracheal intubation and mechanical ventilation. MAS-related mortality rate due to severe injuries of the lung parenchyma and the development of pulmonary hypertension, can exceed 20 %. Other complications, including air leak syndrome (ALS), occur in 10-30 % of children with MAS. Surfactant lavage may be one of the clinical tools that avoids extracorporeal membrane oxygenation (ECMO) in severe MAS cases. This clinical observation is also of interest because a mature, even post-term newborn with MAS subsequently developed a typical bronchopulmonary dysplasia (BPD), which required proper treatment.

Представлен обзор современных исследований о применении сурфактантного лаважа новорожденным с тяжелыми проявлениями синдрома аспирации мекония (САМ), иллюстрированный описанием клинического случая. Околоплодные воды могут быть окрашены меконием в 8-20 % всех родов, причем после полных 42 недель гестации частота САМ достигает 23-52 %. От 2 до 9 % новорожденных, у которых воды были окрашены меконием, впоследствии отмечаются клинические проявления САМ. Около трети новорожденных с САМ нуждаются в интубации трахеи и искусственной вентиляции легких. Летальность при САМ в связи с тяжелыми повреждениями паренхимы легких и развитием легочной гипертензии может превышать 20 %. Другие осложнения, включая синдром утечки воздуха (СУВ), встречаются у 10-30 % детей с САМ. Лаваж сурфактантом может быть одним из клинических инструментов, который позволяет избежать использования экстракорпоральной мембранной оксигенации (ЭКМО) в тяжелых случаях САМ. Приведенное клиническое наблюдение представляет интерес еще и тем, что у зрелого, даже переношенного ребенка с САМ в последующем сформировалась типичная бронхолегочная дисплазия (БЛД), которая требовала соответствующего лечения.

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The authors declare that there are no conflicts of interest present.