title: Change of Cerebral Oxygenation during Surfactant Treatment in Preterm Infants: "LISA" versus "InSurE" Procedures.
abstract: ObjectivesThe aim of the study was to compare the effects on cerebral oxygenation in preterm infants of two different procedures for surfactant administration: the LISA (low-invasive method of surfactant administration) and the InSurE (Intubation, SURfactant administration, Extubation).Study DesignTwenty premature infants with respiratory distress syndrome were assigned to receive surfactant either by "LISA" (n= 10) or "InSurE" (n= 10) procedure. Patients were continuously studied by near-infrared spectroscopy (NIRS) for the measurement of cerebral regional oxygenation (rSO2C) and calculation of cerebral fractional oxygen extraction rate (cFTOE), and NIRS data were recorded 30 minutes before (T0) surfactant administration, during the procedure (Tproc), and 30 (T1), 60 (T2T2), and 120 minutes (T3) afterward. Cerebral blood flow velocity (CBFV) was studied in the anterior cerebral artery atT0,T1, andT3.ResultsSpO2significantly decreased atTprocin comparison withT0,T1,T2, andT3and the decrease was higher in the LISA than in the InSurE group. rSO2C was lower attprocandT3in the LISA than in the InSurE group. cFTOE was higher attproc,t2, andt3in the LISA group than in the InSurE group. CBFV did not change during the study periods in both groups.ConclusionsThe LISA and InSurE procedures transiently decreased rSO2C in our population, and the decrease was higher in the LISA group. Consistently, there was a contemporary increase in cFTOE that was higher in the LISA than in the InSurE group, suggesting that it represents a compensatory mechanism.
authors.affiliation: Division of Neonatology, Careggi University Hospital, Florence, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Bertini
authors.affiliation: Division of Neonatology, Careggi University Hospital, Florence, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Coviello
authors.affiliation: Division of Neonatology, Careggi University Hospital, Florence, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Gozzini
authors.affiliation: Division of Neonatology, Careggi University Hospital, Florence, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Bianconi
authors.affiliation: Division of Neonatology, Careggi University Hospital, Florence, Italy.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Bresci
authors.affiliation: Division of Neonatology, Careggi University Hospital, Florence, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Leonardi
authors.affiliation: Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Dani
mesh_terms: D001783:Blood Flow Velocity / Q000187:drug effects / Q000502:physiology; D001921:Brain / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000378:metabolism*; D002560:Cerebrovascular Circulation / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal / Q000379:methods; D007441:Intubation, Gastrointestinal; D007442:Intubation, Intratracheal; D008297:Male; D010092:Oximetry; D010100:Oxygen / Q000097:blood; D011446:Prospective Studies; D011663:Pulmonary Surfactants / Q000008:administration & dosage*; D012127:Respiratory Distress Syndrome, Newborn / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000378:metabolism*; D019265:Spectroscopy, Near-Infrared; D016896:Treatment Outcome; D017585:Ultrasonography, Doppler, Transcranial
chemical_list: D011663:Pulmonary Surfactants; D010100:Oxygen