Affiliations: Department of Pediatrics, Boston University School of
Medicine, Boston, MA, USA | Department of Biostatistics, Boston University,
Boston, MA, USA | Department of Pediatrics, Boston Medical Center,
Boston, MA, USA | Department of Pediatrics, University of Arkansas for
Medical Sciences (UAMS), Little Rock, AR, USA | Department of Pediatrics and Obstetrics and
Gynecology, UAMS, Little Rock, AR, USA
Note: [] Corresponding author: Jeffrey R. Kaiser, MD, MA, Arkansas
Children's Hospital 800 Marshall Street, Slot 512 Little Rock, AR 72202, USA.
Tel.: +1 501 364 1028; Fax: +1 501 364 4264; E-mail:
kaiserjeffreyr@uams.edu
Abstract: Objective: To determine whether type and timing of surfactant
preparation affect cerebral blood flow (CBF) hemodynamics differently. Study design: Two sites monitoring cerebral hemodynamics
during surfactant administration. Beractant (4.0 ml/kg) and poractant (2.5
ml/kg first dose, 1.25 ml/kg subsequent doses) were administered according to
the manufacturer. CBF velocity (CBFv) was assessed before and after the first
(Site A) and second (Site B) doses of beractant and poractant. Results: At Site A, 10 infants (birth weight 690 ± 133 g)
were studied. CBFv decreased 28.9 ± 5.1% following the first dose of
surfactant; there were no differences between beractant and poractant. At Site
B, 16 infants (birth weight 896 ± 311 g) were studied. CBFv increased 47.4
± 35.7% after the second dose of beractant and did not change after the
second dose of poractant. Conclusion: This is a preliminary report of two related trials
examining CBFv responses to beractant and poractant. CBFv decreased similarly
after the first dose of beractant and poractant. CBFv increased after the
second dose of beractant, but not after poractant. Cerebral hemodynamic
responses between the first and second doses may be due to differences in
quantities of airway fluid, while second dose differences between beractant and
poractant may be due to differences in dose-volume.
