Meconium aspiration syndrome and persistent pulmonary hypertension of the newborn

The focus of this article will be to critically assess the nursing care provided to an infant, “James”, with meconium stained aspiration (MAS) and persistent pulmonary hypertension (PPHN) with particular regard to James's hypercapnia, hypoxia, tachypnoea, low mean systemic blood pressure (BP), low pre and post ductal oxygen saturations and cool extremities. The hypercapnia, hypoxia and tachypnoea and underlying physiological mechanisms will be related to the pathophysiology of MAS, and the low mean systemic BP, oxygen saturations and cool extremities will be related to the PPHN. Knowledge of the underlying physiological mechanisms which will then be used to discuss the nursing care provided, and the impact it had on James's condition. The overarching aim of nursing care was to reduce James's need for respiratory support and return his blood gases to normal. The interventions that supported this such as positioning, fluid balance and comfort measures will be looked at in more detail. Other aspects, including drugs that were used will also be discussed.