Abstract
CBFV were studied in the internal carotid arteries through the anterior fontanelle with a pulsed Doppler in 23 infants (mean BW= 1500 ± 144g) before and after SURF. The time averaged Mean Flow (MFV), Mean Systolic (SFV) and Mean Diastolic (DFV) of the CBFV were calculated. End Diastolic (EDV) and Peak Systolic CBFV were also measured. CBFV, arterial blood pressures (BP), arterial blood gases, & FiO2 were measured approximately 10 min before and after a 10 min instillation of SURF. After SURF the infants as a group showed a drop in the EDV (p=0.04) and a decrease in the pH and BE (p=0.04, both). However, MFV increased 20% after SURF in 11 infants and dropped 18% in 12. 3/12 developed reverse diastolic flow. Before SURF, the 12 infants who dropped the MFV had pH 7.29 and the 11 infants with an elevation of the MFV during SURF 7.34 (p= 0.04). The 11 infants who increased the MFV dropped the pH during SURF (7.34 vs 7.31; p=0.045). Incidence of IVH was 30% (5gr I-II and 2gr III). Two infants enlarged previous IVH and 4 developed new IVH after SURF (mean time at diagnosis = 44 ± 8 hrs after SURF). All these 6 infants were in the group who dropped the MFV during SURF. The risk of IVH was higher in the 12 infants who dropped the MFV during SURF than in the 11 infants who increased the MFV (p=0.02). Before SURF, the 6 infants who bled had a lower pH (p= 0.05), a lower BW (p=0.05) and required higher FiO2 (p=0.04) than the 17 infants who did not bleed after SURF. However, during SURF these 6 infants had a higher % drop in BP and in all CBFV (p=0.01, both) than the 17 infants who did not bleed after SURF. SURF administration is associated with profound changes in CBFV depending upon preexisting clinical conditions. Infants who drop MFV shortly after SURF have a higher risk of developing IVH or increasing previous IVH within 48 hours.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Buatos, R., Golden, J., Bejar, R. et al. CEREBRAL BLOOD FLOW VELOCITES (CBFV), INTRAVENTRICULAR BLEEDING (IVH) AND SURFACTANT (SURF) ADMINISTRATION. Pediatr Res 32, 740 (1992). https://doi.org/10.1203/00006450-199212000-00043
Issue Date:
DOI: https://doi.org/10.1203/00006450-199212000-00043