An international study co-ordinated by Menzies Research Institute Tasmania has shown that babies with meconium aspiration syndrome (MAS) who received therapeutic lung cleansing had a lower mortality rate than those who received only standard care.

An international study co-ordinated by Menzies Research Institute Tasmania has shown that babies with meconium aspiration syndrome (MAS) who received therapeutic lung cleansing had a lower mortality rate than those who received only standard care.

The international randomised controlled trial, called the lessMAS trial, was undertaken in 20 neonatal intensive care units in six countries - Australia, New Zealand, Singapore, Malaysia, Taiwan and Japan.

The findings of the trial were recently published online in the international journal, The Journal of Pediatrics.

Meconium aspiration syndrome (MAS) is a respiratory disease that occurs in infants born at or near full term. It occurs when a baby passes meconium (the first bowel action) before birth and some of this meconium is inhaled into the lung.

Meconium causes multiple problems in the lung, including airway blockage and inflammation, and results in respiratory difficulties which are often very severe and potentially fatal.

Infants with MAS receive supportive treatments, but none actually remove meconium from the lung and thereby overcome the underlying cause of MAS.

Until recently, babies were left to deal with the meconium themselves. Lung cleansing therapy, known as lavage, removes that meconium from the lungs.

The study group for the trial were infants with severe MAS who had respiratory failure and needed mechanical ventilation with a high oxygen requirement. Infants were randomly assigned to receive either lavage therapy or standard care. Infants who received the lung cleansing were then treated as per usual for any infant with MAS.

Chief investigator for the study Menzies' Honorary Fellow, Associate Professor Peter Dargaville, says the findings showed that the group of babies with MAS who received lavage had a lower mortality rate of 10 per cent compared with 23 per cent in the group who received only standard care.

In particular, survival rate without needing heart lung bypass (ECMO) was better amongst babies treated with lavage than in those receiving standard care.

"This has potential implications in all centres worldwide looking after infants with MAS, especially centres that can offer high level supportive treatment, but not ECMO," Associate Professor Dargaville said.

"This trial has shown us that babies who are critically ill on life support can tolerate a lung cleansing procedure, using a large volume of cleansing fluid." he said.

 "Moreover, the group of infants treated with lung cleansing appeared to have a lower mortality rate, and were also able to have their ventilator pressures reduced more rapidly than those receiving standard care".

"In the meantime, neonatal intensive care specialists who are regularly looking after infants with severe MAS should consider learning the technique of lung lavage."

"This is a treatment that might well save a baby's life, but the prescribed method of lavage must be carefully followed for it to be safe and potentially effective."

Claire Beckett and Nigel Herbert's daughter, Maya, was born at the Royal Hobart Hospital in August this year. She had severe MAS, and required specialised ventilation. A lavage procedure of exactly the type used in the lessMAS trial was performed after which there was a considerable improvement in lung function.

Maya was able to come off the ventilator within three days, required no additional oxygen after that time, and went home after seven days. The average baby with severe MAS is ventilated for around five days, on oxygen for 11 days, and stays in hospital for more than two weeks.

"Naturally we were all delighted with Maya's response to the lavage procedure, and the rapid forward progress she made after it," Associate Professor Dargaville said.

The lessMAS trial was funded by the Australian National Health and Medical Research Council.

Information Released by:

Fiona Horwood, Communications Manager

Phone: 6226 7751 Mobile: 0409 357 384

Email: Fiona.Horwood@menzies.utas.edu.au

Contact:

Phone:

Email: