Cerebrovascular regulation and neonatal brain injury

The cardiovascular response to birth asphyxia is altered by the surrounding environment

“…This finding is similar to previous studies showing that cold water and sympathetic stimulation causes a significant reduction in CaBF 32 33. Although, those studies demonstrated that the reduction resulted from cerebral vasoconstriction, we are unsure of the exact mechanism(s) accounting for the significantly lower mean and end-diastolic CaBF and higher PI in the warm-water group compared with the air group (figure 4).…”

Effect of sustained inflation duration; resuscitation of near-term asphyxiated lambs

“…A 30 s SI may thus facilitate a smoother circulatory transition. It is, however, important to acknowledge that large rapid swings in cardiac function caused by ventilation, resuscitation and volume expansion have been associated with cerebral pathology, even in term infants 33. The marked increase in CBP and HR in response to the single 30 s SI may cause a significantly higher cerebral blood flow, which, in a compromised newborn whom is unable to autoregulate, may result in haemorrhage.…”

Anticonvulsant Effectiveness and Hemodynamic Safety of Midazolam in Full-Term Infants Treated with Hypothermia

“…Drug accumulation due to impaired elimination can augment sedation and induce adverse events such as hypotension. Hypotension should be avoided, since it may cause neurologic effects due to transient cerebral hypoperfusion, in particular during pressure-passive circulation in neonates with perinatal asphyxia [8,9,10]. The aim of this study was to evaluate the anticonvulsant effectiveness and hemodynamic safety of midazolam in hypothermic newborns and to provide dosing guidance.…”