Non-invasive cerebral pulse rate monitoring during two low-cardiac-output events after birth – A case report

A female, term neonate required cardiopulmonary resuscitation (CPR) for 45 s after vaginal birth. A novel cerebral pulsatile near-infrared spectroscopy (pNIRS) mode guided chest compressions during CPR, as it showed a cerebral pulse rate of around 100 per minute, suggesting sufficient perfusion pressure. After initial stabilization and intubation due to minimal breathing efforts, she spontaneously developed broad complex tachycardia. During this instance, the pNIRS detected a regular cerebral pulse rate, indicating stable cerebral perfusion and reassuring that CPR and emergency defibrillation were not required. While requiring further investigation, pNIRS holds promise for guiding and optimizing neonatal CPR.