Solevåg Anne Lee, Cheung Po-Yin, Schmölzer Georg M
Department of Paediatric and Adolescent Medicine, Akershus University Hospital, 1478 Lørenskog, Norway.
Division of Paediatric and Adolescent Medicine, Oslo University Hospital, 0424 Oslo, Norway.
Healthcare (Basel). 2020 Jan 10;8(1):17. doi: 10.3390/healthcare8010017.
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.
本文的主要目的是概述在新生动物胸部按压（CC）期间直接或间接测量脑血流量（CBF）的研究。我们的主要研究问题是：不同的胸部按压方式如何影响脑血流量？我们还旨在讨论测量脑血流量的不同方法的优缺点。基于对Medline Ovid的检索，我们确定了三项关于仔猪的研究，这些研究调查了不同的胸部按压：通气（C:V）比率，以及三项关于仔猪的研究，这些研究调查了同步通气下的持续胸部按压。在所有研究中，通过颈动脉（CA）血流和局部脑氧合（rcSO）间接测量脑血流量。颈动脉为大脑提供血流，但也为脑外结构提供血流。颈内动脉和颈外动脉的相对大小及其血流分布因物种而异。局部脑氧合是一种非侵入性的连续测量方法，但它不仅反映脑血流量，还反映脑血容量和脑内氧代谢率。与标准的3:1 C:V方法相比，以120次/分钟的按压频率进行同步通气下的持续胸部按压，以及将胸部按压与持续充气相结合（四项仔猪研究和一项羔羊研究）能使脑血流量更快恢复。
