• Mioara D Manole, Lesley M Foley, Hitchens T Kevin TK, Patrick M Kochanek, Robert W Hickey, Hülya Bayir, Henry Alexander, Chien Ho, and Robert S B Clark.
• Division of Pediatric Emergency Medicine, Department of Pediatrics, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania 15213-2583, USA. mioara.manole@chp.edu
• J. Cereb. Blood Flow Metab. 2009 Jan 1; 29 (1): 197-205.

AbstractCerebral blood flow (CBF) alterations after asphyxial cardiac arrest (CA) are not defined in developmental animal models or humans. We characterized regional and temporal changes in CBF from 5 to 150 mins after asphyxial CA of increasing duration (8.5, 9, 12 min) in postnatal day (PND) 17 rats using the noninvasive method of arterial spin-labeled magnetic resonance imaging (ASL-MRI). We also assessed blood-brain barrier (BBB) permeability, and evaluated the relationship between CBF and mean arterial pressure after resuscitation. After all durations of asphyxia CBF alterations were region dependent. After 8.5- and 9-min asphyxia, intense subcortical hyperemia at 5 min was followed by return of CBF to baseline values by 10 mins. After 12-min asphyxia, hyperemia was absent and hypoperfusion reached a nadir of 38% to 65% of baselines with the lowest values in the cortex. BBB was impermeable to gadoteridol 150 mins after CA. CBF in the 12-min CA group was blood pressure passive at 60 min assessed via infusion of epinephrine. ASL-MRI assessment of CBF after asphyxial CA in PND 17 rats reveals marked duration and region-specific reperfusion patterns and identifies possible new therapeutic targets.

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