Features of the cardiovascular system in newborns, carrying out the cerebral ischemia

Abstract

Aim. To identify the features of the function of the cardiovascular system in newborns with cerebral ischemia (CI) of hypoxic origin. Materials and methods. In the neurological department of the children's hospital in 64 newborns coming from maternity hospitals with CI, a clinical and instrumental examination confirmed the diagnosis of CI of hypoxic origin after excluding structural damage to cardiomyocytes, infectious, traumatic and dysmetabolic causes of its occurrence; 12.2% of children were diagnosed with CI of easy degree, 81.2% CI of moderate severity; the control group consisted of 24 healthy full-term children, comparable in age. All patients were examined by a pediatric cardiologist with an electrocardiogram (ECG), echocardiographic ultrasound screening assessment of the heart (ECHO-CG), Holter electrocardiogram monitoring, cardiointervalography. Results. In newborns, who underwent CI, there is a higher heart rate, more often there is a single supraventricular extrasystole. Bradycardia with heart rate less than 100 beats/min, sino-atrial block II degree, atrioventricular block II degree were recorded only in newborns after CI. According to ECHO-CG data, a hypokinetic type of hemodynamics takes place in newborns with CI. A decrease in cardiac output reflects a narrowing of the adaptive range of its regulation. In every second child with CI, homeostasis is achieved by a sharp overstrain of the autonomic nervous system regulatory systems, which is most likely based on a shift in regulation from the reflex vegetative to the humoral-metabolic type. As the severity of CI progresses, depletion of reserves to support reflex and humoral homeostasis has been established. Conclusion. In connection with the revealed clinical and instrumental features of the cardiovascular system, newborns with CI who came under the supervision of pediatricians at children's clinics, at the age of one month, in addition to a neurological examination, an examination of a pediatric cardiologist with an ECG is shown. If, according to ECG data, heart rhythm and conduction abnormalities, fluctuations in the duration of the QT interval are detected, CI and/or HM-ECG are indicated to determine further observation tactics.