The Ewha Medical Journal
Ewha Womans University School of Medicine
Original Article

Changes of Cerebral Hemodynamics of the Hyaline Membrane Disease Using Doppler Ultrasonography

Jeong Hyun Yoo, Kyung Hee Kim*

Copyright ⓒ 1999. Ewha Womans University School of Medicine. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published Online: Jun 30, 1999

Abstract

Objectives

To access the changes of cerebral blood flow velocity according to the time after surfactant administration, we prospectively studied in the Hyaline Membrane Disease using Doppler ultrasonography.

Material and Method

The patients were 26 infants. The mean gestational age was 3l4wks (range, 184 to 38wk). The ratio of male : female was 16 : 10, mean weight was 1.76±0.88Kg, Apgar score at 5min was 6.9, and type of delivery was C-section : vaginal delivery 19 : 4. Before and after, 10, 30min, 1, 6, l2hr, 1, 3, 5, 7days after surfactant administration, peak systolic and end-diastolic flow velocity(PSFV, EDFV) were estimated by Doppler method measuring MCA flow velocity. The Resistive index was calculated according to the mathematics. For the evaluation of the clinical status, systolic and diastolic systemic BP, PaO2, PaCO2, FiO2, pH, and respiratory rate(RR) were checked.

Results

The cerebral blood flow velocity showed initial increase of PSFV just after synthetic surfactant administration, and the increased PSFV continued until the 30 minites and then decreased. PSFV returns to initial level at 6hr, and then increased again. The changes of EDFV was not significant. The changes of RI & PI were no significant changes. The effects of surfactant to the systemic BP had no significance. The changes of PaCO2 and PaO2 were not significant. FiO2 showed steady improvement. Initial tachypnea and acidosis progressively improved without clinical significance.

Conclusion

The administration of Surfactant in the HMD patients results in transient increase of cerebral blood flow velocity.

Keywords: Hyaline membrane disease; Doppler ultrasonography; Cerebral blood flow