2016
DOI: 10.1111/chd.12352
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Cognitive Dysfunction in Children with Heart Disease: The Role of Anesthesia and Sedation

Abstract: As physicians and caregivers of children with congenital heart disease, we are aware of the increasing need for procedures requiring anesthesia. While these procedures may be ideal for medical and cardiac surgical management, the risks and benefits must be assessed carefully. There are well known risks of cardiovascular and respiratory complications from anesthesia and sedation and a potentially under-appreciated risk of neurocognitive dysfunction. Both animal and human studies support the detrimental effects … Show more

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Cited by 19 publications
(18 citation statements)
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“…In contrast to cardiac MRI, which requires a long examination time in the range of 30 minutes to one hour, cardiothoracic CT requires a short examination time less than several minutes; therefore, a lighter level of sedation is generally sufficient for the latter. In addition to the well-known risk of cardiovascular and respiratory complications, long-term neurodevelopmental impairment has recently been recognized to be a potential complication of deeper, repeated, or prolonged sedation in young children (18). It should be emphasized that sufficient levels of sedation necessary for quality pediatric cardiothoracic CT can almost always be achieved without using general anesthesia and endotracheal intubation.…”
Section: Patient Preparationmentioning
confidence: 99%
“…In contrast to cardiac MRI, which requires a long examination time in the range of 30 minutes to one hour, cardiothoracic CT requires a short examination time less than several minutes; therefore, a lighter level of sedation is generally sufficient for the latter. In addition to the well-known risk of cardiovascular and respiratory complications, long-term neurodevelopmental impairment has recently been recognized to be a potential complication of deeper, repeated, or prolonged sedation in young children (18). It should be emphasized that sufficient levels of sedation necessary for quality pediatric cardiothoracic CT can almost always be achieved without using general anesthesia and endotracheal intubation.…”
Section: Patient Preparationmentioning
confidence: 99%
“…The ongoing debate of the safety of GABA antagonists and NMDA agonists in the neontatal brain for hours in the operating room has not changed the practice of sedating neonates and infants in the ICU for days at a time. The effect of long‐term ICU sedation in neonates is not known.…”
Section: Postoperative Carementioning
confidence: 99%
“…Following the publication of several studies that identified an association between exposure to pediatric anesthetics and cognitive deficits in animals, SmartTots was established to promote the awareness of this information and to drive research to develop evidence‐based recommendations for the clinical use of sedatives and anesthetics in infants and toddlers . In 2014, SmartTots and the FDA convened a group of experts to update the 2012 Consensus Statement for both parents and healthcare providers, which outlines the state of the pediatric anesthesia science and promoting awareness of the potential risks . This statement was further endorsed by 19 pediatric and anesthesiologist societies, including the American Society of Anesthesiologists, American Academy of Pediatrics, and Society for Pediatric Anesthesia.…”
Section: Ppp Deliverables and Post‐market Safetymentioning
confidence: 99%
“…[77][78][79] In 2014, SmartTots and the FDA www.cts-journal.com convened a group of experts to update the 2012 Consensus Statement for both parents and healthcare providers, which outlines the state of the pediatric anesthesia science and promoting awareness of the potential risks. 80,81 This statement was further endorsed by 19 pediatric and anesthesiologist societies, including the American Society of Anesthesiologists, American Academy of Pediatrics, and Society for Pediatric Anesthesia. In addition to being a scientific resource, SmartTots also supports research looking at long-term neurocognitive changes following pediatric anesthetic exposure to develop best practices related to pediatric anesthesia and sedative use.…”
Section: Pediatric Medication Safetymentioning
confidence: 99%