Is Supplemental Oxygen Needed in Cardiac Compression?—The Influence of Oxygen on Cerebral Perfusion in Severely Asphyxiated Neonates With Bradycardia or Cardiac Asystole
Background: Previous studies have investigated hemodynamic recovery using 21% vs. 100% oxygen during cardiopulmonary resuscitation (CPR) with chest compression (CC) in term infants. Animal studies indicate that systemic circulatory recovery is the same whether 21 or 100% oxygen is used during neonat...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-11-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fped.2019.00486/full |
| _version_ | 1818115582750359552 |
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| author | Anne Lee Solevåg Georg M. Schmölzer Georg M. Schmölzer Po-Yin Cheung Po-Yin Cheung |
| author_facet | Anne Lee Solevåg Georg M. Schmölzer Georg M. Schmölzer Po-Yin Cheung Po-Yin Cheung |
| author_sort | Anne Lee Solevåg |
| collection | DOAJ |
| description | Background: Previous studies have investigated hemodynamic recovery using 21% vs. 100% oxygen during cardiopulmonary resuscitation (CPR) with chest compression (CC) in term infants. Animal studies indicate that systemic circulatory recovery is the same whether 21 or 100% oxygen is used during neonatal CPR. One of the main goals of resuscitation is to maintain cerebral oxygen delivery and prevent cerebral hypo- and hyperoxygenation. Oxygen delivery to the brain depends on cerebral hemodynamics, concentration of inhaled oxygen and blood oxygen content. The aim of this paper was to synthesize available research about cerebral oxygen delivery during CPR using different oxygen concentrations. Our research questions included how do different oxygen concentrations during CPR with CC influence cerebral perfusion and oxygen delivery, and how do cerebral hemodynamics during CC influence outcomes.Methods: A search in Medline Ovid using the search terms hypoxia AND oxygen AND cerebrovascular circulation AND infant, newborn. Inclusion criteria included studies of hypoxia and resuscitation of term infants. Studies were excluded if no measures of cerebral blood flow (CBF), oxygenation, or perfusion were reported.Results: The search retrieved 21 papers. None of the studies directly fulfilled our inclusion criteria. The reference lists of some of the retrieved papers provided relevant animal studies with slightly conflicting results regarding blood flow and oxygen delivery to the brain using 21 or 100% oxygen. No study in term infants was identified, but we included one study in preterm infants. Studies in asphyxiated animals indicate that 100% oxygen increases CBF and oxygenation during and after CC with a potential increase in oxidative stress.Conclusion: In asphyxia, cerebral autoregulation may be impaired. Pure oxygen administration during CC may result in cerebral hyperperfusion and increased cerebral oxygen delivery, which may be associated with oxidative stress-related damage to the brain tissue. As systemic circulatory recovery is the same whether 21 or 100% oxygen is used during neonatal CPR, it is important to investigate whether brain damage could be aggravated when 100% oxygen is used. |
| first_indexed | 2024-12-11T04:08:55Z |
| format | Article |
| id | doaj.art-f344c6bf606c406284ff0026ec0b2e5b |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-11T04:08:55Z |
| publishDate | 2019-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-f344c6bf606c406284ff0026ec0b2e5b2022-12-22T01:21:27ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602019-11-01710.3389/fped.2019.00486493526Is Supplemental Oxygen Needed in Cardiac Compression?—The Influence of Oxygen on Cerebral Perfusion in Severely Asphyxiated Neonates With Bradycardia or Cardiac AsystoleAnne Lee Solevåg0Georg M. Schmölzer1Georg M. Schmölzer2Po-Yin Cheung3Po-Yin Cheung4Department of Paediatric and Adolescent Medicine, Akershus University Hospital, Lørenskog, NorwayNeonatal Research Unit, Centre for the Studies of Asphyxia and Resuscitation, Royal Alexandra Hospital, Edmonton, AB, CanadaDepartment of Pediatrics, University of Alberta, Edmonton, AB, CanadaNeonatal Research Unit, Centre for the Studies of Asphyxia and Resuscitation, Royal Alexandra Hospital, Edmonton, AB, CanadaDepartment of Pediatrics, University of Alberta, Edmonton, AB, CanadaBackground: Previous studies have investigated hemodynamic recovery using 21% vs. 100% oxygen during cardiopulmonary resuscitation (CPR) with chest compression (CC) in term infants. Animal studies indicate that systemic circulatory recovery is the same whether 21 or 100% oxygen is used during neonatal CPR. One of the main goals of resuscitation is to maintain cerebral oxygen delivery and prevent cerebral hypo- and hyperoxygenation. Oxygen delivery to the brain depends on cerebral hemodynamics, concentration of inhaled oxygen and blood oxygen content. The aim of this paper was to synthesize available research about cerebral oxygen delivery during CPR using different oxygen concentrations. Our research questions included how do different oxygen concentrations during CPR with CC influence cerebral perfusion and oxygen delivery, and how do cerebral hemodynamics during CC influence outcomes.Methods: A search in Medline Ovid using the search terms hypoxia AND oxygen AND cerebrovascular circulation AND infant, newborn. Inclusion criteria included studies of hypoxia and resuscitation of term infants. Studies were excluded if no measures of cerebral blood flow (CBF), oxygenation, or perfusion were reported.Results: The search retrieved 21 papers. None of the studies directly fulfilled our inclusion criteria. The reference lists of some of the retrieved papers provided relevant animal studies with slightly conflicting results regarding blood flow and oxygen delivery to the brain using 21 or 100% oxygen. No study in term infants was identified, but we included one study in preterm infants. Studies in asphyxiated animals indicate that 100% oxygen increases CBF and oxygenation during and after CC with a potential increase in oxidative stress.Conclusion: In asphyxia, cerebral autoregulation may be impaired. Pure oxygen administration during CC may result in cerebral hyperperfusion and increased cerebral oxygen delivery, which may be associated with oxidative stress-related damage to the brain tissue. As systemic circulatory recovery is the same whether 21 or 100% oxygen is used during neonatal CPR, it is important to investigate whether brain damage could be aggravated when 100% oxygen is used.https://www.frontiersin.org/article/10.3389/fped.2019.00486/fullnewborn infantasphyxiaoxygenchest compressioncerebral perfusion |
| spellingShingle | Anne Lee Solevåg Georg M. Schmölzer Georg M. Schmölzer Po-Yin Cheung Po-Yin Cheung Is Supplemental Oxygen Needed in Cardiac Compression?—The Influence of Oxygen on Cerebral Perfusion in Severely Asphyxiated Neonates With Bradycardia or Cardiac Asystole Frontiers in Pediatrics newborn infant asphyxia oxygen chest compression cerebral perfusion |
| title | Is Supplemental Oxygen Needed in Cardiac Compression?—The Influence of Oxygen on Cerebral Perfusion in Severely Asphyxiated Neonates With Bradycardia or Cardiac Asystole |
| title_full | Is Supplemental Oxygen Needed in Cardiac Compression?—The Influence of Oxygen on Cerebral Perfusion in Severely Asphyxiated Neonates With Bradycardia or Cardiac Asystole |
| title_fullStr | Is Supplemental Oxygen Needed in Cardiac Compression?—The Influence of Oxygen on Cerebral Perfusion in Severely Asphyxiated Neonates With Bradycardia or Cardiac Asystole |
| title_full_unstemmed | Is Supplemental Oxygen Needed in Cardiac Compression?—The Influence of Oxygen on Cerebral Perfusion in Severely Asphyxiated Neonates With Bradycardia or Cardiac Asystole |
| title_short | Is Supplemental Oxygen Needed in Cardiac Compression?—The Influence of Oxygen on Cerebral Perfusion in Severely Asphyxiated Neonates With Bradycardia or Cardiac Asystole |
| title_sort | is supplemental oxygen needed in cardiac compression the influence of oxygen on cerebral perfusion in severely asphyxiated neonates with bradycardia or cardiac asystole |
| topic | newborn infant asphyxia oxygen chest compression cerebral perfusion |
| url | https://www.frontiersin.org/article/10.3389/fped.2019.00486/full |
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