Surfactant therapy for meconium aspiration syndrome in DSoetomo General Hospital – A case series

INTRODUCTION: Meconium staining of amniotic fluid (MSAF) is a natural phenomenon in pregnant mothers and their fetuses. MSAF may lead to developing Meconium Aspiration Syndrome (MAS). Surfactant replacement therapy has recently emerged as a therapy in MAS, but no guideline outlines how to administer it properly. CASE PRESENTATION: We present two term neonates with severe MAS cases focusing on the bolus surfactant replacement therapy. The first baby was given surfactant at 23 hours after birth and the second baby at 8 hours after birth. We used Survanta (beractant) in the dose of 100 mg/kg BW in both cases. Clinical improvement was observed 24 hours after surfactant bolus administration with different clinical characteristics, treatment approaches, and outcomes. CONCLUSION: In conclusion, therapeutic surfactant bolus in severe MAS may improve outcomes without significant adverse side effects.