Background and aims Meconium aspiration syndrome (MAS) is an important cause of severe respiratory failure in newborn infants. The aim of this study was to evaluate the efficacy of lung lavage with dilute porcine surfactant in ventilated infants with MAS.

Methods In this prospective randomised controlled study ventilated infants with MAS with a gestational age ≥36, birth weight ≥2000 g included. Enrolled infants randomised into two groups; in group 1, two sequential 15 mL/kg aliquots of dilute porcine surfactant (Curosurf, Chiesi Farmaceutici S.p. A., Parma, Italy) with a phospholipid concentration of 5 mg/ml were instilled into the lung. In group 2, 100 mg/kg of porcine surfactant were administered as a bolus. Infants in both groups were evaluated and compared with regard to efficacy, morbidity and mortality.

Results Fourteen infants were randomised. There were no significant differences between two groups in term of demographic characteristics. Median duration of respiratory support was longer in bolus surfactant group, although the difference was not statistically significant (2.2 vs. 7.2 days, p = 0.18). Similarly, duration of oxygen therapy and hospital stay length were shorter in lung lavage group but the difference was statistically insignificant (8.0 vs. 12.7 days, p = 0.32, 11 vs. 18.5 days p = 0.15, respectively). There were no differences in requirement for high frequency ventilation and nitric oxide between the groups.

Conclusion Although it is not statistically significant, preliminary results show that lung lavage with dilute surfactant therapy shortens the duration of respiratory support and hospital stay length.