title: Cerebral blood flow and plasma hypoxanthine in relation to surfactant treatment.
abstract: We have previously reported reduction in EEG activity in preterm babies after tracheal instillation of Curosurf. To elucidate the cause of EEG depression, we have examined cerebral blood flow (CFB), amplitude-integrated EEG (aEEG), mean arterial blood pressure (MABP) and plasma hypoxanthine (Hx) concentration in a group of preterm babies before and immediately after administration of surfactant. No change occurred in CBF immediately after surfactant treatment despite a significant decrease in MABP. At 60 min after surfactant administration, a significant reduction in CBF occurred (p < 0.05). However, when CBF values were corrected for changes in PaCO2, no reduction in CBF was observed. Mean plasma Hx concentration was 11.6 (SD 7.3) mumol/l before surfactant therapy, which decreased significantly to 8.1 (5.8) mumol/l (p < 0.05) 15-30 min after treatment. No correlations were found between plasma Hx concentration and FiO2, a/A pO2, PaCO2, SaO2, arterial blood pressure, CBF or the degree of EEG depression. This study indicates that EEG depression observed after surfactant instillation is not caused by cerebral ischemia.
authors: Department of Neonatology, Rigshospitalet, Copenhagen, Denmark.
authors: A H
authors: AH
authors: Bell
authors: L
authors: L
authors: Skov
authors: K E
authors: KE
authors: Lundstrøm
authors: O D
authors: OD
authors: Saugstad
authors: G
authors: G
authors: Greisen
mesh_terms: D001688:Biological Products; D001794:Blood Pressure / Q000187:drug effects; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D004569:Electroencephalography / Q000187:drug effects; D006801:Humans; D019271:Hypoxanthine; D007042:Hypoxanthines / Q000097:blood*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D007442:Intubation, Intratracheal; D010743:Phospholipids; D011659:Pulmonary Gas Exchange / Q000187:drug effects; D011663:Pulmonary Surfactants / Q000494:pharmacology* / Q000627:therapeutic use*; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D013997:Time Factors; D014980:Xenon Radioisotopes / Q000493:pharmacokinetics
chemical_list: D001688:Biological Products; D007042:Hypoxanthines; D010743:Phospholipids; D011663:Pulmonary Surfactants; D014980:Xenon Radioisotopes; D019271:Hypoxanthine; C068291:poractant alfa