Cowan F, Whitelaw A, Wertheim D, Silverman M
Department of Paediatrics and Neonatal Medicine, Hammersmith Hospital, London.
Arch Dis Child. 1991 Oct;66(10 Spec No):1105-9. doi: 10.1136/adc.66.10_spec_no.1105.
A computer linked Doppler system was used to make continuous measurements of cerebral blood flow velocity (CBFV) from the middle cerebral artery, mean arterial blood pressure (MAP) from the umbilical artery, and heart rate before, during, and for 20 minutes after the endotracheal administration of 200 mg/kg of porcine surfactant in 10 preterm infants with respiratory distress syndrome. Within two minutes of surfactant administration, there was a median fall of 6 mm Hg (15%) fall in MAP and 36% in CBFV. There was a change in the Doppler spectra with almost complete loss of diastolic velocities. A rapid reduction in pulmonary vascular resistance with consequent left to right ductal shunting is one possible cause. These acute changes in MAP and CBFV after bolus surfactant administration may increase the risk of intraventricular haemorrhage.
在10名患有呼吸窘迫综合征的早产婴儿中,使用计算机连接的多普勒系统,在气管内给予200mg/kg猪肺表面活性物质之前、期间以及之后20分钟,持续测量大脑中动脉的脑血流速度(CBFV)、脐动脉的平均动脉血压(MAP)和心率。给予肺表面活性物质后两分钟内,MAP中位数下降6mmHg(15%),CBFV下降36%。多普勒频谱发生变化,舒张期速度几乎完全消失。肺血管阻力迅速降低,随后出现从左向右的导管分流是一种可能的原因。推注肺表面活性物质后MAP和CBFV的这些急性变化可能会增加脑室内出血的风险。