ECMO for Meconium Aspiration Syndrome

Abstract

Meconium aspiration syndrome (MAS) is a major cause of respiratory distress in term and postterm infants and is one of the common etiologies for severe hypoxemic respiratory failure requiring support with extracorporeal membrane oxygenation (ECMO) in the neonate. MAS was the most common indication for ECMO support in neonates in the late 1980s and early 1990s, with excellent survival. Changes in the perinatal and postnatal management of these infants has contributed to a decreased need for ECMO in uncomplicated MAS, but ECMO maintains an important role in the support of patients with severe respiratory failure despite conventional medical management. A case is presented, followed by key questions around the pre-ECMO and ECMO management of a patient with MAS, followed by a discussion and board-style multiple-choice questions.