Cerebroelectrical depression following surfactant treatment in preterm neonates.
During surfactant treatment of respiratory distress syndrome, 23 premature newborns were investigated with continuous amplitude-integrated electroencephalography (cerebral function monitors). Simultaneously, arterial blood pressure and transcutaneous blood gas values were recorded. A short (less than 10 minutes) but significant decrease in cerebral activity was seen in almost all neonates immediately after the surfactant instillation, in spite of an improved pulmonary function. In 21 of 23 neonates, a transient fall in mean arterial blood pressure of 9.3 mm Hg (mean) occurred coincidently with the cerebral reaction. Neonates in whom intraventricular hemorrhage developed tended to have lower presurfactant mean arterial blood pressure (P greater than .05), but they had a significantly lower mean arterial blood pressure after surfactant instillation (P less than .05). No other differences were found between neonates in whom intraventricular hemorrhage developed and those without intraventricular hemorrhage. The present findings demonstrate that an acute cerebral dysfunction may occur after surfactant instillation. In some vulnerable neonates with arterial hypotension and severe pulmonary immaturity, the fall in mean arterial blood pressure may increase the risk of cerebral complications and could be related to an unchanged rate of intraventricular hemorrhage after surfactant treatment.
Hellström-Westas
L
L
Department of Pediatrics, University Hospital, Lund, Sweden.
Bell
A H
AH
Skov
L
L
Greisen
G
G
Svenningsen
N W
NW
D001688:Biological Products; D001794:Blood Pressure / Q000502:physiology; D002543:Cerebral Hemorrhage / Q000209:etiology*; D002552:Cerebral Ventricles; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000503:physiopathology / Q000628:therapy*; D007442:Intubation, Intratracheal; D008168:Lung / Q000503:physiopathology; D008297:Male; D010743:Phospholipids; D011663:Pulmonary Surfactants / Q000008:administration & dosage / Q000627:therapeutic use*; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000503:physiopathology / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome
D001688:Biological Products; D010743:Phospholipids; D011663:Pulmonary Surfactants; C068291:poractant alfa