23 Effects of porcine surfactant (Curosurf) on cerebral oxygenation and haemodynamics in preterm infants

Abstract

To investigate the cerebral effects of Curosurf, nine ventilated infants (5 boys, 4 girls) were studied by near infrared spectroscopy. Their median gcstauonal age was 30 (range 26-34) weeks and they were 5.5 (2.5-13.5) hours old. Continuous recordings of cerebral oxyhacmoglobin ([HbO2]) and total haemoglobin ([tHb]) from 5 minutes before to 10 minutes after administaiion of Curosurf showed that boih variables fell and then rose above baseline in all infants. The median maximum fall in [HbO2] was 5.06 (range 1.67-8.08) μmol.l−1 and in [tHb] was 1.29 (0.53-2.90) umol.l−1. The calculated fall in cerebral blood volume (CBV) was 0.08 (0.03-0.17) ml.100g−1. [HbO2], [tHbO2] and CBV subsequently rose above the initial baseline values by 1.2 (0.35-17) μmol.l−1, 2.45 (0.29-6.6) μmol.l−1 and 0.13 (0.02-0.38) ml.100g−1 respectively. Measurements of cerebral blood How (CBF) and oxygen delivery (COD) made in live infants between 12-70 minutes before and 19-80 minutes after Curosurf showed that mean CBF was 19 (12-37) ml.100g−1.min−1 before and 26 (10-29) ml.100g−1.min−1 afterwards; mean COD was 2.2 (1.9-4.2) ml.100g−1.min−1 before and 3.4 (1.6-3.7) ml.100g−1.min−1 afterwards. Multiple linear regression analysis showed that CBF and COD were significantly related to ancrial carbon dioxide tension and that surfactant administration had no independent effect. Surfactant was thus associated with only small and iransient changes in cerebral oxygenation and haemodynamics.