Meconium Aspiration Syndrome

Meconium aspiration syndrome is respiratory disease caused by aspiration of meconium stained amniotic fluid before or during birth. Meconium causes airway obstruction, chemical pneumonitis, surfactant dysfunction and pulmonary hypertension.

• Do not routinely suction the trachea solely because meconium is present.

• Prioritize effective ventilation when the newborn is apnoeic or bradycardic.

• Provide oxygen, CPAP or mechanical ventilation according to severity.

• Surfactant may be considered in severe disease.

• Persistent pulmonary hypertension may require inhaled nitric oxide where available.

• Treat pneumothorax immediately when clinically significant.

Clinical toolsCalculators

BMI GCS EDD Parkland Formula

Corrected Sodium Corrected Calcium Anion Gap Creatinine Clearance Insulin Calculations qSOFA Wells PE Wells DVT CHA₂DS₂-VASc HAS-BLED CURB-65 Centor/McIsaac

Necrotising Enterocolitis

Necrotising enterocolitis is acute inflammatory and ischaemic injury of the neonatal intestine, predominantly affecting premature infants. Disease may progress from feeding intolerance to transmural necrosis, perforation, sepsis and death.

• Stop enteral feeds immediately.

• Insert nasogastric or orogastric tube for decompression.

• Provide IV fluids and parenteral nutrition when prolonged bowel rest is required.

• Start broad spectrum IV antibiotics covering Gram positive, Gram negative and anaerobic organisms.

• If a standard neonatal sepsis regimen is being used, add anaerobic cover such as metronidazole when NEC is suspected.

• Obtain urgent paediatric surgical assessment for perforation, necrotic bowel, worsening acidosis or clinical deterioration despite medical treatment.

Meconium Aspiration Syndrome

Overview

Clinical Features

Diagnosis

Management

Overview

Clinical Features

Diagnosis

Management