Surfactant administration acutely affects cerebral and systemic hemodynamics and gas exchange in very-low-birth-weight infants - 24/08/11
, C.Heath Gauss, MS, D.Keith Williams, PhD
Reprint requests: Jeffrey R. Kaiser, MD, MA, Arkansas Children's Hospital, 800 Marshall St, 512, Little Rock, AR 72202.Abstract |
Objectives |
To determine whether surfactant administration affects cerebral and systemic hemodynamics and gas exchange in very low birth weight infants and to determine the predominant factor influencing changes in mean cerebral blood flow velocity (mCBFv) after surfactant instillation.
Study design |
Fourteen very low birth weight infants with respiratory distress syndrome had continuous monitoring of mCBFv, Paco2, mean arterial blood pressure (MABP), and Pao2 before, during, and after the second dose of surfactant. Peak values and relative changes of the 4 variables for 45 minutes after surfactant were calculated. Logistic regression was used to determine the predominant factor influencing changes in mCBFv after surfactant.
Results |
Birth weight was 832 ± 162 grams and gestational age was 25.7 ± 1.5 weeks. The time from birth to monitoring was 6.9 ± 1.0 hours. Mean CBFv increased 75.7% ± 51.6% after surfactant and peaked at 14.4 ± 5.9 minutes. Paco2 was highly associated (OR=107.3, P < .0001) with mCBFv; as Paco2 increased, mCBFv increased. In contrast, MABP (OR=6.7, P=.047) had less impact on mCBFv. Pao2 was not associated with mCBFv.
Conclusions |
The increases in mCBFv after surfactant administration were predominantly due to increases in Paco2 and not changes in MABP.
Le texte complet de cet article est disponible en PDF.Abbreviations : ABG, CBF, CBFv, MABP, mCBFv, VLBW
Plan
 | Dr Kaiser was supported by a National Institute of Neurological Disorders and Stroke grant 1-K23-NS43185-01. The University of Arkansas for Medical Sciences General Clinical Research Center (M01RR14288) also supported this study. There are no potential, perceived, or real conflicts of interest. |
Vol 144 - N° 6
P. 809-814 - juin 2004 Retour au numéro
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