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

Kristina Sobotka, Graeme Polglase, Georg Marcus Schmolzer, Peter G Davis, Claus Klingenberg, Stuart Brian Hooper

Research output: Contribution to journalArticleResearchpeer-review

13 Citations (Scopus)

Abstract

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.
Original languageEnglish
Pages (from-to)395 - 400
Number of pages6
JournalPediatric Research
Volume78
Issue number4
DOIs
Publication statusPublished - 2015

Cite this

Sobotka, Kristina ; Polglase, Graeme ; Schmolzer, Georg Marcus ; Davis, Peter G ; Klingenberg, Claus ; Hooper, Stuart Brian. / Effects of chest compressions on cardiovascular and cerebral hemodynamics in asphyxiated near-term lambs. In: Pediatric Research. 2015 ; Vol. 78, No. 4. pp. 395 - 400.
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title = "Effects of chest compressions on cardiovascular and cerebral hemodynamics in asphyxiated near-term lambs",
abstract = "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.",
author = "Kristina Sobotka and Graeme Polglase and Schmolzer, {Georg Marcus} and Davis, {Peter G} and Claus Klingenberg and Hooper, {Stuart Brian}",
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Effects of chest compressions on cardiovascular and cerebral hemodynamics in asphyxiated near-term lambs. / Sobotka, Kristina; Polglase, Graeme; Schmolzer, Georg Marcus; Davis, Peter G; Klingenberg, Claus; Hooper, Stuart Brian.

In: Pediatric Research, Vol. 78, No. 4, 2015, p. 395 - 400.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Effects of chest compressions on cardiovascular and cerebral hemodynamics in asphyxiated near-term lambs

AU - Sobotka, Kristina

AU - Polglase, Graeme

AU - Schmolzer, Georg Marcus

AU - Davis, Peter G

AU - Klingenberg, Claus

AU - Hooper, Stuart Brian

PY - 2015

Y1 - 2015

N2 - 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.

AB - 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.

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