Early post-operative neurodevelopment and visual assessment in neonates with congenital heart disease undergoing cardiac surgery

Abstract

Objective: Assessment of neurobehaviour and visual function of newborns with congenital heart disease during post-operative period to identify infants at risk of neurodevelopmental and visual impairment.Study design: Prospective study that include 45 newborns that underwent cardiac surgery. Newborn Behavioral Observations test (NBO) and "ML Battery of Optotypes" were used for assessment.Results: The median NBO global score was 2.4 [2.1-2.6]. Total days of oral morphine [p=0.005] and total days of sedation [p=0.009] were strongly related to abnormal evaluations. Time of cerebral regional oxygen saturation (CrSO2) under 40% during surgery and increased lactate were related with abnormal motor evaluation. Only 14.5% of the patients presented pathological results in visual evaluation.Conclusions: We have demonstrated alterations in attention, autonomic, motor and oral motor function. Duration of sedative medication, time of CrSO2 under 40% during surgery and increased lactate are the most important risk factors. No signi cant visual impairment was detected.