Object: To evaluate the effects of pulmonary surfactant (PS) therapy on cerebral oxygen metabolism in preterm infants through near infrared spectrum instrument (NIRS). Methods: Preterm infants with respiratory distress syndrome (RDS) that met the inclusion criteria were treated with intubation-surfactant-extubation (INSURE) combined with PS therapy if continuous positive airway pressure (CPAP) treatment failed within 2 h after birth. Preterm infants treated with CPAP alone were extracted as the control group. NIRS was used to monitor the cerebral oxygen saturation (ScO2) before treatment

during the treatment process and after treatment 5-min time window

the blood oxygen saturation (ScO2) was monitored

and the fractional tissue oxygen extraction (FTOE) was calculated. Results: Preterm infants born in Guangzhou Women and Children’s Medical Center from Mar. 2018 to Feb. 2019 who met the criteria were extracted

totally 24 cases in the treatment group and 25 cases in the control group. There were no statistically significant differences in clinical characteristics

ScO2 and FTOE levels before PS therapy between two groups. During administration of the treatment group

the ScO2 level was significantly higher than the baseline level (82.1±6.4 vs 77.0±3.7

t=3.362

P=0.002)

and the FTOE level was significantly lower than the baseline level (0.11±0.05 vs 0.19±0.05

t=5.552

P=0.000). ScO2 and FTOE levels returned to the baseline levels 5 min after administration. During administration

the rate of change in ScO2 (ratio to baseline level) in the treatment group was higher than that in the control group (1.049 (from 1.026 to 1.122) vs 1.000 (from 0.972 to 1.013)

Z=135.0

P=0.001)

while the rate of change in FTOE in the treatment group was greater than that in the control group (0.560 (from 0.378 to 0.794) vs 0.938 (from 0.860 to 1.110)

Z=99.00

P=0.000)

and there was no significant difference in the rate of change in ScO2 and FTOE in the control group and the baseline level in the corresponding duration (P>0.05). Conclusion: The application of PS in the treatment of preterm infants with RDS can cause significant changes in cerebral oxygen metabolism

an increase in ScO2 and a decrease in FTOE

providing a more rational approach to the treatment of respiratory diseases in clinical preterm infants