Aspiration of meconium produces respiratory distress of various severity and outcome. To evaluate whether the initial chest roentgenogram (0 to 8 hours of age) can be used to predict the outcome, an analysis of 80 cases with clinical and roentgenographic features of aspiration syndrome was undertaken. Infiltration was seen in 62, consolidation or atelectasis in 44, hyperinflation in 37, air leak in 25, pleural effusion in 16, and increased cardiothymic shadow in 16. Consolidation or atelectasis, most commonly associated with thick meconium aspiration, appeared to be the most significant determinant of poor outcome. Infants who had consolidation or atelectasis were more ill, had lower pH, higher fraction of inspired oxygen, higher alveolar-arterial oxygen gradients, and required longer duration of oxygen intake than those infants who had no consolidation or atelectasis. Thus, the initial chest roentgenogram can be used for predicting outcome in infants with meconium aspiration syndrome.
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