Background/Aim: The aim of the study was to compare the effects on cerebral oxygenation of two procedures for surfactant (SF) administration: LISA (less-invasive SF administration) and InSurE (intubation, SF administration, extubation).
Methods: Twelve newborn piglets with SF-deficient lung injury produced by bronchoalveolar lavages were randomly assigned to receive SF (Poractant alfa) either by LISA (n=6) or InSurE (n=6) procedure. Piglets were studied by near-infrared-spectroscopy (NIRS) for the measurement of cerebral tissue-oxygen-index (cTOI) and calculation of cerebral fractional tissue oxygen extraction (cFTOE). NIRS data were recorded before SF administration, immediately after procedure, 1, 5, 15, 30 min and every 30 min until the end of experimental period, at 180 min. Pulmonary, systemic and cerebral effects (carotid blood flow and histological analysis) were also evaluated.
Results: After bronchoalveolar lavages, newborn piglets developed mild respiratory distress syndrome (FiO2:1, pH<7.2, PaCO2>70 mmHg, PaO2<70 mmHg, Cdyn<0.5 ml/cmH2O/kg). Rapid improvement in pulmonary status was observed in both SF-treated groups. LISA and InSurE procedures induced a transient and brief decrease of SpO2, cTOI and increase of cFTOE, immediately or 1 min after SF administration, respectively. After this point, there were no significant differences between groups in any of the parameters studied. Moreover, both SF-treated groups showed low brain injury scores.
Conclusion: In newborn piglets with mild RDS, our results suggest that cerebral oxygenation may be affected transiently (<1min) by SF administration using LISA or InSurE procedures. No injury to the developing brain was observed associated with these SF administration procedures. 
Supported by: ISCIII-PI14/024-FEDER/FSE, IT583-13 and Chiesi-Farmaceutici.

0444 - EFFECT OF “INSURE” AND “LISA” SURFACTANT ADMINISTRATION TECNIQUES ON CEREBRAL OXYGENATION IN SURFACTANT DEFICIENT NEWBORN PIGLETS.