Changes of cerebral blood flow and carbon dioxide reactivity of cerebral vessels in children after cardiopulmonary resuscitation / 中华急诊医学杂志

ABSTRACT

Objective To observe the changes of cerebral blood flow velocities and carbon dioxide (CO_2) reactivity of cerebral vessels in children after cardiopulmonary resuscitation,and the relationship between the changes of cerebral blood flow and outcome.Methods The waveforms,cerebral blood flow velocities of left middle cerebral artery and extracranial internal carotid artery were monitored by Transcranial Doppler (TCD) in 35 post-resuscitation children. Glasgow coma score (GCS) was estimated at the same time.They were divided into three groups according to the diastolic blood flow velocities:low perfusion group,high perfusion group and near-normal perfusion group.CO_2 reactivity of cerebral vessels was induced by hyperventilation in 26 children under ventilation.Results In both low and high perfusion groups,GCS and CO_2 reactivity of cerebral vessels were significantly lower than that of near-normal perfusion group (P＜0.05);the numbers of died and withdrawing treatment patients were significantly higher than that of near-normal perfusion group (P＜0.01).Conclusion TCD monitoring is a useful technique for estimating cerebral perfusion,outcome and CO_2 reactivity of cerebral vessels of children after cardiopulmonary resuscitation.A secondary ischemic event may be caused by a forced hyperventilation therapy in the condition without TCD monitoring in post-resuscitation patients.