Cerebral blood flow and plasma hypoxanthine in relation to surfactant treatment

Acta Paediatr. 1994 Sep;83(9):910-4. doi: 10.1111/j.1651-2227.1994.tb13169.x.


We have previously reported reduction in EEG activity in preterm babies after tracheal instillation of Curosurf. To elucidate the cause of EEG depression, we have examined cerebral blood flow (CFB), amplitude-integrated EEG (aEEG), mean arterial blood pressure (MABP) and plasma hypoxanthine (Hx) concentration in a group of preterm babies before and immediately after administration of surfactant. No change occurred in CBF immediately after surfactant treatment despite a significant decrease in MABP. At 60 min after surfactant administration, a significant reduction in CBF occurred (p < 0.05). However, when CBF values were corrected for changes in PaCO2, no reduction in CBF was observed. Mean plasma Hx concentration was 11.6 (SD 7.3) mumol/l before surfactant therapy, which decreased significantly to 8.1 (5.8) mumol/l (p < 0.05) 15-30 min after treatment. No correlations were found between plasma Hx concentration and FiO2, a/A pO2, PaCO2, SaO2, arterial blood pressure, CBF or the degree of EEG depression. This study indicates that EEG depression observed after surfactant instillation is not caused by cerebral ischemia.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biological Products*
  • Blood Pressure / drug effects
  • Cerebrovascular Circulation / drug effects*
  • Electroencephalography / drug effects
  • Humans
  • Hypoxanthine
  • Hypoxanthines / blood*
  • Infant, Newborn
  • Infant, Premature, Diseases / drug therapy*
  • Infant, Premature, Diseases / metabolism
  • Infant, Premature, Diseases / physiopathology
  • Intubation, Intratracheal
  • Phospholipids*
  • Pulmonary Gas Exchange / drug effects
  • Pulmonary Surfactants / pharmacology*
  • Pulmonary Surfactants / therapeutic use*
  • Respiratory Distress Syndrome, Newborn / drug therapy*
  • Respiratory Distress Syndrome, Newborn / metabolism
  • Respiratory Distress Syndrome, Newborn / physiopathology
  • Time Factors
  • Xenon Radioisotopes / pharmacokinetics


  • Biological Products
  • Hypoxanthines
  • Phospholipids
  • Pulmonary Surfactants
  • Xenon Radioisotopes
  • Hypoxanthine
  • poractant alfa