Researchers at the University of California San Diego evaluated the effects of endotracheal intubation and surfactant on the neonatal brain using a 3-channel neonatal EEG. Surfactant administration was associated with brain wave suppression on EEG in 18 (62%) of 29 infants treated. (p<0.008). Nine infants exhibited EEG suppression during endotracheal intubation, all having received premedication; 5 infants had EEG suppression during endotracheal suctioning. Brain wave suppression was not correlated with SpO2, BP, heart rate, or TcCO2. 
COMMENT. Endotracheal surfactant administration has reduced neonatal mortality and improved lung function in infants with respiratory distress syndrome. The adverse effects on neonatal brain electrical activity require further study of the EEG, using full neonatal electrode placement and including long-term outcome.