Effect of the Duration of Deep Hypothermic Circulatory Arrest on the Neurodevelopmental Outcomes in Children Undergoing Cardiac Surgery.

IF 1.4 Q3 PEDIATRICS
Abdullah H Ghunaim, Basma Aljabri, Ahmed Dohain, Ghassan S Althinayyan, Abdulaziz I Aleissa, Ahmad T Alshebly, Rayan A Alyafi, Tareg M Alhablany, Ahmed M Nashar, Osman O Al-Radi
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Abstract

Background/Objectives: Deep hypothermic circulatory arrest (DHCA) is safe, but subtle neurodevelopmental deficits may persist far beyond the perioperative period. We aimed to investigate the relationship between DHCA duration and neurodevelopmental outcomes in young children undergoing cardiac surgery with DHCA. Methods: Children aged < 42 months, including neonates who underwent cardiac surgery using DHCA without regional perfusion techniques, were included as the DHCA group. Children in the same age range who underwent cardiac surgery without DHCA were included as the control group. All enrolled patients underwent neurodevelopmental assessment using the Bayley Scales of Infant and Toddler Development (BSTID) by a trained pediatrician, and 17 DHCA patients and 6 control patients completed the BSTID assessment. Results: Both groups showed no significant preoperative, operative, or postoperative differences. Adjusted multivariable analysis revealed that prematurity and age at assessment were significant changing predictors of each of the BSTID components (p < 0.001), except for the gross motor component, where only age at assessment was a significant adjusting predictor. Longer DHCA was associated with lower fine and gross motor BSTID components; however, the association was not statistically significant (p = 0.06). Conclusions: Long-duration DHCA without regional perfusion techniques may be associated with less optimal neurodevelopmental outcomes.

深低温循环休克持续时间对接受心脏手术儿童神经发育结果的影响
背景/目的:深度低体温循环骤停(DHCA)是安全的,但细微的神经发育障碍可能会持续到围术期之后。我们旨在研究使用 DHCA 进行心脏手术的幼儿的 DHCA 持续时间与神经发育结果之间的关系。方法:将年龄小于 42 个月的儿童(包括新生儿)纳入 DHCA 组,他们在没有区域灌注技术的情况下接受了 DHCA 心脏手术。未使用 DHCA 进行心脏手术的同龄儿童作为对照组。所有入组患者均接受了由受过培训的儿科医生使用贝利婴幼儿发育量表(BSTID)进行的神经发育评估,其中17名DHCA患者和6名对照组患者完成了BSTID评估。结果显示两组患者在术前、术中和术后均无明显差异。调整后的多变量分析表明,早产儿和评估时的年龄是 BSTID 各项指标发生变化的重要预测因素(p < 0.001),但粗大运动指标除外,只有评估时的年龄是重要的调整预测因素。较长的 DHCA 与较低的精细和粗大运动 BSTID 要素相关,但相关性在统计学上并不显著(p = 0.06)。结论不使用区域灌注技术的长时间 DHCA 可能与较差的神经发育结果有关。
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来源期刊
Pediatric Reports
Pediatric Reports PEDIATRICS-
CiteScore
2.10
自引率
0.00%
发文量
55
审稿时长
11 weeks
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