Is Surfactant Lavage the Answer?
John P. Kinsella, M.D. Section of Neonatology The Children’s Hospital, University of Colorado School of Medicine Denver, Colorado Hypoxemic respiratory failure affects approximately 80,000 newborn infants each year in the United States alone (greater than the number of cases of acute respiratory distress syndrome in adults) (1), at an estimated hospital cost of $4.4 billion (2). Of this group of newborns who suffer hypoxemic respiratory failure, more than one-third are born at or near full-term gestation, and the most common etiology in this group is meconium aspiration syndrome. Despite advances in neonatal intensive care over the last 2 decades, meconium aspiration syndrome remains one of the most vexing clinical conditions to manage and is the most common indication for treatment with extracorporeal membrane oxygenation (3). Aspiration of meconium typically occurs after fetal hypoxic/ischemic stress leading to intestinal peristalsis, meconium contamination of the amniotic fluid, and
