To evaluate the efficacy of glucocorticoids in the treatment of infants with meconium aspiration syndrome, a double-blind study using hydrocortisone or a lactose placebo was undertaken. Thirty-five infants were included in the study. No significant differences in arterial Po2, Pco2, pH, A-aDo2 gradients, in requirement for assisted ventilation, or in survival were demonstrated between the groups. In control infants, a significant decrease (p<0.01) in respiratory distress score was found at 48 to 72 hours of age; in treated infants, it was seen only after 72 hours. The infants in the treated group took a significantly longer (p<0.01) period of time to wean to room air than those in the control group (68.9±9.6 hours vs 36.6±6.9 hours). On the basis of these observations, hydrocortisone is not recommended for treatment of MAS.
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