Changes in Newborn’ Cerebral Blood Flow on the First and the Second Day Following Cardiopulmonary Resuscitation

Purpose of the study: To determine the relationship between the extent of cardiopulmonary resuscitation (CPR) in full-term newborns and changes in the cerebral blood flow velocities on the first days of life.Materials and methods: We performed a prospective study of full-term newborns (n = 73) who experienced perinatal asphyxia (pH in the umbilical artery 7.2 mmol/l and less and/or BE > 10 mmol/l, requirement of CPR and the Apgar score on the 5th minute was 7 points and less). Group I newborns required only positive-pressure ventilation (PPV), group II newborns required PPV and chest compressions (CC), and group III newborns required PPV, CC, and medications to restore the vital functions. The extent of CPR was compared to cerebral blood circulation parameters (maximal systolic velocity (Vs), end-diastolic velocity (Vd), and vascular resistance index (RI)) in the anterior cerebral arteries (ACA) measured on the first and the second days after birth.Results: The parameters of cerebral blood circulation measured on the first day of life did not correlate with the extent of CPR. On the second day of life, blood circulation parameters differed depending on the extent of CPR. In group I mean Vs was 32.31 cm/s, in group II – 44.15 cm/s, and in group III – 36.01 cm/s (p < 0.02). In group I mean Vd was 11.65 cm/s, in group II – 18.63 cm/s, and in group III – 17.95 cm/s (p < 0.03). In group I mean RI was 0.63, in group II – 0.59, and in group III – 0.45 (p < 0.05).Conclusion: On the second day of life, cerebral blood circulation parameters in the anterior cerebral arteries correlated with the extent of CPR: newborns who underwent extensive CPR (PPV and CC with or without medications) had statistically significantly higher Vs and Vd and lower RI, compared to neonates who only underwent PPV. Purpose of the study: To determine the relationship between the extent of cardiopulmonary resuscitation (CPR) in full-term newborns and changes in the cerebral blood flow velocities on the first days of life. Materials and methods: We performed a prospective study of full-term newborns (n = 73) who experienced perinatal asphyxia (pH in the umbilical artery 7.2 mmol/l and less and/or BE > 10 mmol/l, requirement of CPR and the Apgar score on the 5th minute was 7 points and less). Group I newborns required only positive-pressure ventilation (PPV), group II newborns required PPV and chest compressions (CC), and group III newborns required PPV, CC, and medications to restore the vital functions. The extent of CPR was compared to cerebral blood circulation parameters (maximal systolic velocity (Vs), end-diastolic velocity (Vd), and vascular resistance index (RI)) in the anterior cerebral arteries (ACA) measured on the first and the second days after birth. Results: The parameters of cerebral blood circulation measured on the first day of life did not correlate with the extent of CPR. On the second day of life, blood circulation parameters differed depending on the extent of CPR. In group I mean Vs was 32.31 cm/s, in group II – 44.15 cm/s, and in group III – 36.01 cm/s (p < 0.02). In group I mean Vd was 11.65 cm/s, in group II – 18.63 cm/s, and in group III – 17.95 cm/s (p < 0.03). In group I mean RI was 0.63, in group II – 0.59, and in group III – 0.45 (p < 0.05). Conclusion: On the second day of life, cerebral blood circulation parameters in the anterior cerebral arteries correlated with the extent of CPR: newborns who underwent extensive CPR (PPV and CC with or without medications) had statistically significantly higher Vs and Vd and lower RI, compared to neonates who only underwent PPV.