Increasing duration of deep hypothermic circulatory arrest is associated with an increased incidence of postoperative electroencephalographic seizures

Gaynor, J. William; Nicolson, Susan C.; Jarvik, Gail P.; Wernovsky, Gil; Montenegro, Lisa M.; Burnham, Nancy; Hartman, Deborah S.; Louie, Andy; Spray, Thomas L.; Clancy, Robert R.

doi:10.1016/j.jtcvs.2005.02.065

Cited by 137 publications

(89 citation statements)

References 23 publications

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“…15,50,[117][118][119][120] Perioperative seizures may be associated with particular CHD anatomies, aortic arch obstruction, and genetic conditions, as well as use of DHCA and prolonged DHCA time. 117,119, 121 Newburger et al 117 showed that clinical seizures within 7 days after heart surgery were more common in infants whose repair was performed with a predominant DHCA strategy (11.5%) versus with predominant low-flow CPB (1.2%). In the same cohort, seizures seen by electroencephalography within 48 hours of surgery were also more frequent in the DHCA group (25.7% versus 12.9%).…”

Section: Perioperative Seizures Related To Chd Surgerymentioning

confidence: 99%

Neurodevelopmental Outcomes in Children With Congenital Heart Disease: Evaluation and Management

Marino¹,

Lipkin²,

Newburger³

et al. 2012

Circulation

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1,334

1,156

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Background— The goal of this statement was to review the available literature on surveillance, screening, evaluation, and management strategies and put forward a scientific statement that would comprehensively review the literature and create recommendations to optimize neurodevelopmental outcome in the pediatric congenital heart disease (CHD) population. Methods and Results— A writing group appointed by the American Heart Association and American Academy of Pediatrics reviewed the available literature addressing developmental disorder and disability and developmental delay in the CHD population, with specific attention given to surveillance, screening, evaluation, and management strategies. MEDLINE and Google Scholar database searches from 1966 to 2011 were performed for English-language articles cross-referencing CHD with pertinent search terms. The reference lists of identified articles were also searched. The American College of Cardiology/American Heart Association classification of recommendations and levels of evidence for practice guidelines were used. A management algorithm was devised that stratified children with CHD on the basis of established risk factors. For those deemed to be at high risk for developmental disorder or disabilities or for developmental delay, formal, periodic developmental and medical evaluations are recommended. A CHD algorithm for surveillance, screening, evaluation, reevaluation, and management of developmental disorder or disability has been constructed to serve as a supplement to the 2006 American Academy of Pediatrics statement on developmental surveillance and screening. The proposed algorithm is designed to be carried out within the context of the medical home. This scientific statement is meant for medical providers within the medical home who care for patients with CHD. Conclusions— Children with CHD are at increased risk of developmental disorder or disabilities or developmental delay. Periodic developmental surveillance, screening, evaluation, and reevaluation throughout childhood may enhance identification of significant deficits, allowing for appropriate therapies and education to enhance later academic, behavioral, psychosocial, and adaptive functioning.

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Section: Perioperative Seizures Related To Chd Surgerymentioning

confidence: 99%

Neurodevelopmental Outcomes in Children With Congenital Heart Disease: Evaluation and Management

Marino¹,

Lipkin²,

Newburger³

et al. 2012

Circulation

Self Cite

1,334

1,156

View full text Add to dashboard Cite

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“…A study was recently completed at The Children's Hospital of Philadelphia to define the contemporary incidence of postoperative seizures in a large group of children undergoing newborn heart surgery for serious forms of CHDs [40,41]. These children were participating in a larger study examining the relationship between polymorphisms of the apolipoprotein E gene and subsequent neurodevelopmental outcome [42].…”

Section: Long-term Monitoring For Electrographic Seizuresmentioning

confidence: 99%

Prolonged Electroencephalogram Monitoring for Seizures and Their Treatment

Clancy

2006

Clinics in Perinatology

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“…This observation could also explain the normal IQ in our cohort, because parental school education was within the normal range (table 3) [26]. In contrast to our findings, motor development is frequently impaired after a CPB operation and is negatively related to hospital stay and postoperative neurologic abnormalities, especially seizures, severe preoperative acidosis, and hypoxia [23,27]. In our study population, the patients developed no significant postoperative neurologic abnormalities [8].…”

Section: Discussionmentioning

confidence: 49%

Long-Term Neurodevelopmental Outcome of Children Treated with Tri-Iodothyronine after Cardiac Surgery: Follow-Up of a Double-Blind, Randomized, Placebo-Controlled Study

Mittnacht

Choukair²,

Kneppo³

et al. 2015

Horm Res Paediatr

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Background: Transient thyroid dysfunction occurs in children after cardiopulmonary bypass (CPB). We demonstrated significant benefits of acute postoperative tri-iodothyronine (T3) treatment for recovery and myocardial function. Now we report the long-term neurodevelopment of these children. Methods: Twenty-eight children (70% of the original study population) could be recruited for a follow-up examination (median age 10.7 years, range 10-19.6 years) retaining the double-blind, randomized, placebo-controlled protocol. Cognitive function and motor development were tested, as were growth and thyroid and cardiac functions. Results: The median full-scale intelligence quotient of all children was within the reference range and similar in the placebo and T3 groups. Tests for motor and cognitive functions, growth, and thyroid and cardiac functions revealed concurrent results. Conclusions: Overall intellectual development is preserved in adolescents treated with CPB in infancy irrespectively of low postoperative thyroid hormone concentrations. While acute postoperative T3 treatment in children after CPB improves recovery, no significant long-term effects on neurodevelopment could be detected. We therefore speculate that transient postoperative thyroid dysfunction by means of nonthyroidal illness syndrome is predominantly mediated by extranuclear, nongenomic mechanisms and thus acutely affects the cardiovascular system but not the development of the central nervous system mediated by genomic mechanisms.

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Increasing duration of deep hypothermic circulatory arrest is associated with an increased incidence of postoperative electroencephalographic seizures

Cited by 137 publications

References 23 publications

Neurodevelopmental Outcomes in Children With Congenital Heart Disease: Evaluation and Management

Neurodevelopmental Outcomes in Children With Congenital Heart Disease: Evaluation and Management

Prolonged Electroencephalogram Monitoring for Seizures and Their Treatment

Long-Term Neurodevelopmental Outcome of Children Treated with Tri-Iodothyronine after Cardiac Surgery: Follow-Up of a Double-Blind, Randomized, Placebo-Controlled Study

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