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
