A Blinded Comparative Trial Between Synthetic Surfactant (Exosurf) and Bovine Surfactant (BLES) on Cardiac Hemodynamics 1099

The effects of surfactant (S) replacement therapy for hyaliane membrane disease (HMD) on cardiac output and patent ductus arteriosus (PDA) volumetric shunting is unknown. Also natural surfactant has been implicated in intraventricular hemorrhage in the preterm secondary to decreased cardiac output without altering ventilatory parameters

Forty-two paired Doppler echocardiographic studies (DE) were performed on thirty-three ventilated premature infants with HMD as part of a blinded randomized multicentre trial of Exosurf vs BLES for the treatment of HMD with a/A ratio of < 0.22. Left and right ventricular cardiac indices (Q_LV& Q_RV were calculated using cross-sectional area and flow velocity integral in the great arteries prior and one hour after S. PDA volumetric shunting was calculated as the shunt fraction (Q_LV/Q_RV) in infants with PDA. There were no ventilatory changes made between the paired studies and simultaneous arterial blood gas analyses were performed. Results are shown in table as mean±SD

Table 1 No caption available.

Conclusion: There were no significant changes in either Q_LV or Q_RV following either S. However, there was a trend towards increased PDA shutning following BLES and decreased shunting following Exosurf (P=0.1)