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Inflammatory indices in meconium aspiration syndrome
Author(s) -
Hofer Nora,
Jank Katharina,
Strenger Volker,
Pansy Jasmin,
Resch Bernhard
Publication year - 2016
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.23349
Subject(s) - medicine , meconium aspiration syndrome , mechanical ventilation , white blood cell , sepsis , absolute neutrophil count , meconium , c reactive protein , gastroenterology , ventilation (architecture) , inflammation , anesthesia , pregnancy , fetus , toxicity , mechanical engineering , genetics , neutropenia , engineering , biology
Summary Introduction Meconium aspiration syndrome (MAS) is linked to inflammation, but data on the patterns of hematological indices and C‐reactive protein (CRP) in MAS are lacking. The aim of the study was to evaluate CRP, white blood cell count (WBC), absolute neutrophil count (ANC), and immature‐to‐total neutrophil ratio (IT‐ratio) in MAS and to assess their association with disease severity. Methods Retrospective cross‐sectional study including 239 consecutively admitted neonates with MAS to a level III NICU. Neonates with early onset sepsis were excluded. Results Neonates with severe MAS (invasive mechanical ventilation for <7 days) and very severe MAS (invasive mechanical ventilation for ≥7 days or high frequency ventilation or ECMO) had higher CRP and IT‐ratio compared to neonates with non‐severe MAS (no invasive mechanical ventilation) during the first 2 days of life (CRP: 13.0 and 40.9 vs. 9.5 mg/L, P = 0.039 and <0.001, respectively) and neonates with very severe MAS had lower WBC and ANC. All four inflammatory indices correlated significantly with duration of invasive mechanical ventilation, duration of respiratory support and with length of hospital stay, arterial hypotension, and persistent pulmonary hypertension. Neonates with all four inflammatory indices beyond the normal range had a more than 20‐fold increase in risk for very severe MAS. Conclusion High CRP and IT‐ratio and low WBC and ANC values were closely linked to a more severe course of MAS during the early phases of the disease. These findings reflect the role of inflammation in the pathogenesis of MAS. Pediatr Pulmonol. 2016;51:601–606 . 2015 Wiley Periodicals, Inc.