Chest Compression in Neonatal Cardiac Arrest: Cerebral Blood Flow Measurements in Experimental Models

Overview

Journal Healthcare (Basel)

Specialty Health Services

Date 2020 Apr 15

PMID 32284508

Citations 1

Authors

Anne Lee Solevag

Po-Yin Cheung

Georg M Schmolzer

Affiliations

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Abstract

The main aim of this paper was to provide an overview of studies that measured cerebral blood flow (CBF), directly or indirectly, during chest compression (CC) in neonatal animals. Our main research question was: how did different ways of performing CC influence CBF. We also aimed to discuss strengths and limitations of different methods for measuring CBF. Based on a search in Medline Ovid, we identified three studies in piglets that investigated different CC:ventilation (C:V) ratios, as well as three piglet studies investigating continuous CC with asynchronous ventilation. CBF was measured indirectly in all studies by means of carotid artery (CA) flow and regional cerebral oxygenation (rcSO). The CA provides flow to the brain, but also to extracerebral structures. The relative sizes of the internal and external carotid arteries and their flow distributions are species-dependent. rcSO is a non-invasive continuous measure, but does not only reflect CBF, but also cerebral blood volume and the metabolic rate of oxygen in the brain. Continuous CC with asynchronous ventilation at a CC rate of 120/min, and combining CC with a sustained inflation (four studies in piglets and one in lambs) provided a faster CBF recovery compared with the standard 3:1 C:V approach.

Citing Articles

Single versus continuous sustained inflations during chest compressions and physiological-based cord clamping in asystolic lambs.

Schmolzer G, Roberts C, Blank D, Badurdeen S, Miller S, Crossley K Arch Dis Child Fetal Neonatal Ed. 2021; 107(5):488-494.

PMID: 34844983 PMC: 9411918. DOI: 10.1136/archdischild-2021-322881.

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