Study identification (title, authors, journal)

Year of publication

Data bases

Study type


Principal results

Nona, J; Santos, C; Bento, AM; Resende, C; Rodrigues, A; Pinheiro, A; Nascimento, O; Valido, AM. High frequency oscillatory ventilation in meconium aspiration syndrome. Einstein.



Retrospective analysis

Evaluate and compare the performance and morbidity associated with meconium aspiration syndrome in newborns in the maternity ward or admitted from outside hospitalized in our Neonatal Intensive Care Unit and in high-frequency oscillatory ventilation.

- The therapy consists of the administration of surfactant in 22 newborns (13 admitted outside), nitric oxide in 12 (seven admitted outside) and magnesium sulfate in 4 (3 admitted outside).

- The average ventilation time was 6 days (4.5 days for those born in the maternity ward and 10 days for those admitted outside), and the median time of oxygen supplementation was 10 days (4.5 days for those born in the maternity ward and 15 days for those admitted from outside).

- The average length of stay was 13 days (11 days for those born in the maternity ward and 16 days for those admitted outside). A newborn admitted from outside died. The ventilatory strategy used, did not observe statistically significant differences between the two groups of newborns, except for the time of need for supplementation with oxygen, which was higher in the group of newborns admitted outside.

Daripa M, Caldas EMG, Flores LPO, Waldvogel BC, Guinsburg R, Almeida MFB. Asfixia perinatal associada à mortalidade neonatal precoce: estudo populacional dos óbitos evitáveis. Rev. paul. pediatr.



Cohort study

Compare the epidemiological profile of preventable early neonatal deaths associated with perinatal asphyxia according to the region where the death occurred in the State of São Paulo.

- Between 2001 and 2003, 1.71 deaths per 1000 live births were associated with perinatal asphyxia, corresponding to 22% of early neonatal deaths.

- Of the 2873 preventable deaths, 761 (27%) occurred in São Paulo, capital; 640 (22%), in the capital’s metropolitan region; and 1472 (51%), in the interior of the state.

- Meconium aspiration syndrome was present in 18% of deaths.

Bhutani, VK. Developing a systems approach to prevent meconium aspiration syndrome: lessons learned from multinational studies. Journal of Perinatology



Retrospective analysis

Evaluate the evidences about the crucial steps necessary in the prevention of meconium aspiration syndrome, concomitant neonatal death and illness in the perinatal context of the diversified health services.

- Treatment options continuous airway pressure (CPAP), conventional ventilation management, has been replaced by synchronized intermittent mandatory ventilation (SIMV), high frequency oscillatory ventilation (HFOV), surfactant, inhaled nitric oxide (iNO), and oxygenation by extracorporeal membrane (ECMO). Exogenous surfactant therapy has been successfully implemented. However, these innovative interventions are expensive, require a sophisticated infrastructure and are not universally accessible.

- Over the period of 6 years (1995-2000) the birth of babies in an urban perinatal center (Philadelphia, USA) was analyzed. 14.5% (3370/23,175) births were of babies with suspected MAS and 4.6% of them were diagnosed with MAS. Overall, 26% of babies (40/155) with MAS required necessary ventilatory support; of these, only 20% (8/40) needed innovative ventilatory support. None died or needed ECMO.