Randomized trial examining cerebral haemodynamics following artificial or animal surfactant.
To determine the effects of animal and artificial surfactants on cerebral haemodynamics, 20 premature babies receiving mechanical ventilation were randomized to receive Curosurf or Exosurf surfactant. Anterior cerebral artery blood flow velocity (CABFV) was measured using Doppler ultrasound before and up to 2 h after treatment. Following animal surfactant there was a rapid reduction in CABFV (median -36%, range -43% to +8%, p < 0.01), whereas artificial surfactant resulted in a slower rise which was less marked (median +20%, range -7% to +62%, p < 0.05). There were no significant changes in blood pressure. Two hours after administration, the oxygenation index (OI) improved significantly only in babies receiving animal surfactant. In this group there was a significant association between the change in CABFV at 1 min and the change in OI at 2h (r = 0.66, p < 0.05). Animal surfactant produces rapid improvements in ventilation which are associated with marked alterations in cerebral haemodynamics.
Murdoch
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Neonatal Unit, Royal London Hospital, Whitechapel, UK.
Kempley
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D001688:Biological Products; D002536:Cerebral Arteries / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D004338:Drug Combinations; D005233:Fatty Alcohols / Q000494:pharmacology* / Q000627:therapeutic use; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007385:Intermittent Positive-Pressure Ventilation; D010743:Phospholipids; D010767:Phosphorylcholine; D011092:Polyethylene Glycols / Q000494:pharmacology* / Q000627:therapeutic use; D011663:Pulmonary Surfactants / Q000494:pharmacology* / Q000627:therapeutic use; D012039:Regional Blood Flow / Q000187:drug effects; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy*; D018709:Statistics, Nonparametric
D001688:Biological Products; D004338:Drug Combinations; D005233:Fatty Alcohols; D010743:Phospholipids; D011663:Pulmonary Surfactants; D010767:Phosphorylcholine; D011092:Polyethylene Glycols; C047049:dipalmitoylphosphatidylcholine, hexadecanol, tyloxapol drug combination; C068291:poractant alfa