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Neuropediatrics 2017; 48(02): 098-103
DOI: 10.1055/s-0037-1598647
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Change of Cerebral Oxygenation during Surfactant Treatment in Preterm Infants: “LISA” versus “InSurE” Procedures

Giovanna Bertini
1   Division of Neonatology, Careggi University Hospital, Florence, Italy
,
Caterina Coviello
1   Division of Neonatology, Careggi University Hospital, Florence, Italy
,
Elena Gozzini
1   Division of Neonatology, Careggi University Hospital, Florence, Italy
,
Tommaso Bianconi
1   Division of Neonatology, Careggi University Hospital, Florence, Italy
,
Cecilia Bresci
1   Division of Neonatology, Careggi University Hospital, Florence, Italy
,
Valentina Leonardi
1   Division of Neonatology, Careggi University Hospital, Florence, Italy
,
Carlo Dani
2   Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital, Italy
› Author Affiliations
Further Information

Publication History

30 August 2016

26 December 2016

Publication Date:
28 February 2017 (online)

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Abstract

Objectives The 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 Design Twenty 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 (T 0) surfactant administration, during the procedure (T proc), and 30 (T 1), 60 (T 2 T 2), and 120 minutes (T 3) afterward. Cerebral blood flow velocity (CBFV) was studied in the anterior cerebral artery at T 0, T 1, and T 3.

Results SpO2 significantly decreased at T proc in comparison with T 0, T 1, T 2, and T 3 and the decrease was higher in the LISA than in the InSurE group. rSO2C was lower at t proc and T 3 in the LISA than in the InSurE group. cFTOE was higher at t proc, t 2, and t 3 in the LISA group than in the InSurE group. CBFV did not change during the study periods in both groups.

Conclusions The 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.

Keywords

surfactant administration - premature infants - NIRS
 

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