Introduction: Surfactant proteins (SP) have been shown to be inherent proteins of the
human CNS and are altered during acute and chronic disturbances of CSF circulation.
Aim of the study was to examine the changes of surfactant protein concentrations in CSF
of preterm babies suffering from intraventricular hemorrhage.
Patients and Methods: Consecutive CSF samples of 21 preterm infants with
intraventricular hemorrhages (IVH) and posthemorrhagic hydrocephalus (PHHC) were
collected at primary intervention, after 5–10 days and at time of shunt insertion 50
days after hemorrhage. Samples were analyzed for surfactant proteins A, B, C, and G by
ELISA assays and the results were compared to 35 hydrocephalus patients (HC) without
hemorrhage and 6 newborn control patients.
Results and Discussion: Premature patients with IVH showed a significant elevation
of surfactant proteins SP-A, C, and G compared to HC and control groups: mean
values for the respective groups were SP-A 4.19 vs. 1.08 vs. 0.38 ng/ml. Mean SP-C
3.63 vs. 1.47 vs. 0.48 ng/ml. Mean SP-G 3.86 vs. 0.17 vs. 0.2 ng/ml. SP-A and G
concentrations were slowly falling over time without reaching normal values. SP-C levels
declined faster following neurosurgical interventions and reached levels comparable to
those of hydrocephalus patients without hemorrhage.
Conclusion: Intraventricular hemorrhages of premature infants cause posthemorrhagic
CSF flow disturbance and are associated with highly significant elevations of surfactant
proteins A, C, and G independent of total CSF protein concentrations
