Continuous chest compressions with asynchronous ventilations increase carotid blood flow in the perinatal asphyxiated lamb model
| العنوان: | Continuous chest compressions with asynchronous ventilations increase carotid blood flow in the perinatal asphyxiated lamb model |
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| المؤلفون: | Ziad Alhassen, Payam Vali, Amy Lesneski, Peggy Chen, Morgan Hardie, Houssam M. Joudi, Deepika Sankaran, Satyan Lakshminrusimha |
| المصدر: | Pediatric research Pediatric research, vol 90, iss 4 |
| بيانات النشر: | Springer Science and Business Media LLC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Resuscitation, Blood Pressure, Cardiovascular, Pediatrics, 0302 clinical medicine, Neonatal Resuscitation Program, Medicine, Lung, Pediatric, Asphyxia Neonatorum, Respiration, Heart Disease, Carotid Arteries, Anesthesia, Artificial, Public Health and Health Services, Breathing, Arterial blood, Return of spontaneous circulation, Article, Paediatrics and Reproductive Medicine, 03 medical and health sciences, Clinical Research, 030225 pediatrics, Animals, Humans, Asystole, Sheep, Animal, business.industry, Neurosciences, Infant, Newborn, Infant, Blood flow, Newborn, medicine.disease, Respiration, Artificial, Cardiopulmonary Resuscitation, Brain Disorders, Disease Models, Animal, Blood pressure, Animals, Newborn, Regional Blood Flow, Disease Models, Pediatrics, Perinatology and Child Health, Injury (total) Accidents/Adverse Effects, Blood Gas Analysis, business, 030217 neurology & neurosurgery |
| الوصف: | Author(s): Vali, Payam; Lesneski, Amy; Hardie, Morgan; Alhassen, Ziad; Chen, Peggy; Joudi, Houssam; Sankaran, Deepika; Lakshminrusimha, Satyan | Abstract: BackgroundThe neonatal resuscitation program (NRP) recommends interrupted chest compressions (CCs) with ventilation in the severely bradycardic neonate. The conventional 3:1 compression-to-ventilation (C:V) resuscitation provides 90 CCs/min, significantly lower than the intrinsic newborn heart rate (120-160 beats/min). Continuous CC with asynchronous ventilation (CCCaV) may improve the success of return of spontaneous circulation (ROSC).MethodsTwenty-two near-term fetal lambs were randomized to interrupted 3:1 C:V (90 CCs + 30 breaths/min) or CCCaV (120 CCs + 30 breaths/min). Asphyxiation was induced by cord occlusion. After 5 min of asystole, resuscitation began following NRP guidelines. The first dose of epinephrine was given at 6 min. Invasive arterial blood pressure and left carotid blood flow were continuously measured. Serial arterial blood gases were collected.ResultsBaseline characteristics between groups were similar. Rate of and time to ROSC was similar between groups. CCCaV was associated with a higher PaO2 (partial oxygen tension) (22 ± 5.3 vs. 15 ± 3.5 mmHg, p l 0.01), greater left carotid blood flow (7.5 ± 3.1 vs. 4.3 ± 2.6 mL/kg/min, p l 0.01) and oxygen delivery (0.40 ± 0.15 vs. 0.13 ± 0.07 mL O2/kg/min, p l 0.01) compared to 3:1 C:V.ConclusionsIn a perinatal asphyxiated cardiac arrest lamb model, CCCaV showed greater carotid blood flow and cerebral oxygen delivery compared to 3:1 C:V resuscitation.ImpactIn a perinatal asphyxiated cardiac arrest lamb model, CCCaV improved carotid blood flow and oxygen delivery to the brain compared to the conventional 3:1 C:V resuscitation. Pre-clinical studies assessing neurodevelopmental outcomes and tissue injury comparing continuous uninterrupted chest compressions to the current recommended 3:1 C:V during newborn resuscitation are warranted prior to clinical trials. |
| وصف الملف: | application/pdf |
| تدمد: | 1530-0447 0031-3998 |
| DOI: | 10.1038/s41390-020-01306-4 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b76703ca28e2f0a0ccb84d2db464d365 https://doi.org/10.1038/s41390-020-01306-4 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....b76703ca28e2f0a0ccb84d2db464d365 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15300447 00313998 |
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| DOI: | 10.1038/s41390-020-01306-4 |