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Pediatr Res. 2015 Oct;78(4):395-400. doi: 10.1038/pr.2015.117. Epub 2015 Jun 18.

Effects of chest compressions on cardiovascular and cerebral hemodynamics in asphyxiated near-term lambs.

Author information

1
The Ritchie Centre, Monash University, Melbourne, Australia.
2
Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia.
3
Department of Pediatrics, Medical University, Graz, Austria.
4
Neonatal Research, Royal Women's Hospital, Melbourne, Australia.
5
Department of Paediatrics, University Hospital of North Norway, Tromsø, Norway.
6
Paediatric Research Group, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.

Abstract

BACKGROUND:

Chest compressions (CC) and adrenaline administration are recommended in asphyxiated newborns with persistent bradycardia despite effective ventilation. The effects of CC on cerebral blood flow in newborns at birth are unknown. Our aim was to determine the effects of CC, with or without adrenaline administration, on the return of spontaneous circulation, carotid blood flow (CBF), and carotid arterial pressure (CAP) in asphyxiated near-term lambs.

METHODS:

Asphyxia was induced in near-term lambs by clamping the umbilical cord and delaying ventilation onset until spontaneous circulation ceased. Lambs were then resuscitated by positive pressure ventilation along with CC followed by adrenaline administration. CAP and CBF were continuously recorded.

RESULTS:

Mean CAP did not increase significantly during CC and only increased following adrenaline administration. CC did not increase mean CBF but increased CBF amplitude due to increased peak flow and the onset of retrograde flow during diastole. Adrenaline increased mean CBF from 1 ± 2 to 15 ± 5 ml/kg/min and abolished retrograde diastolic CBF, leading to the return in spontaneous circulation.

CONCLUSION:

We conclude that CC with adrenaline administration was required to increase CBF and restore spontaneous circulation in asphyxiated lambs. Low CBF and retrograde diastolic CBF during CC indicate hypoperfusion to the brain.

PMID:
26086644
DOI:
10.1038/pr.2015.117
[Indexed for MEDLINE]
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