'Department of Health and Human services, Victoria, Australia'

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ACS 1613 Massive Aspiration Syndrome

Publication Date: May 2022

Implementation Date: 1/06/2022

ICD 10 AM Edition: Eleventh Edition

Query Number: 3824

Can the Committee please advise whether ACS 1613 Massive aspiration syndrome is still relevant?

Our neonatologists have advised that the advice in this standard is not in line with their clinical criteria. Neonates with Meconium Aspiration Syndrome (MAS) are not always managed with >24hrs of oxygen. Our neonatologists said that Transient Tachypnoea of Newborn (TTN) and MAS should be classified as per documentation, not based on the duration of oxygen therapy as they are two different conditions. Also, neonatal pneumonia due to aspiration is classified to P24.x.

Please also refer to VAHI Clinical guidance Neonatal MAS. This document provides information on MAS and respiratory management.

Should we continue to follow the ACS 1613 even when the clinician states the baby was managed for MAS? Does ACS 1613 Massive Aspiration Syndrome need to be revised?

For example:
Pdx Neonatal pneumonia, meconium aspiration syndrome
Management plan: CPAP, HFNP <24hrs supplemental oxygen given via CPAP

Inpatient notes state # respiratory distress 2nd to meconium aspiration, required period of HFNP, weaned on 27/02 at midday.

Response

VICC acknowledges that advances in clinical practice may mean that a standard becomes out of step with latest clinical advice. However notwithstanding the clinical advice, for classification purposes and consistency in reporting of massive/meconium aspiration syndrome ACS 1613 Massive aspiration syndrome must be applied.

You may wish to make a public submission to IHPA suggesting updates to ACS 1613 in line with the clinical advice.