Continuous electroencephalography (cEEG) in infants with congenital heart disease (CHD)

被引:6
作者
Padiyar, Swetha [1 ]
Friedman, Neil [2 ]
Pestana-Knight, Elia [3 ]
Mossa-Naduvil, Ahsan [3 ]
Franic, Linda [3 ]
Worley, Sarah [4 ]
Aly, Hany [1 ]
机构
[1] Cleveland Clin Childrens Hosp, Dept Neonatol, Cleveland Hts, OH USA
[2] Barrow Neurol Inst Phoenix Childrens Hosp, Dept Neurol, Phoenix, AZ USA
[3] Epilepsy Ctr, Cleveland Clin, Cleveland Hts, OH USA
[4] Dept Quantitat Hlth Sci, Cleveland Clin, Cleveland Hts, OH USA
关键词
HYPOTHERMIC CIRCULATORY ARREST; AMPLITUDE-INTEGRATED ELECTROENCEPHALOGRAPHY; CARDIOPULMONARY BYPASS; NEUROLOGIC STATUS; BRAIN-INJURY; CEREBRAL OXYGENATION; CARDIAC-SURGERY; EEG; CHILDREN; NEWBORNS;
D O I
10.1038/s41390-023-02520-6
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
BackgroundNeonates with congenital heart disease (CHD) undergoing cardiopulmonary bypass (CPB) surgery have increased risk of impaired neurodevelopmental outcomes secondary to brain injury. This study aims to characterize pre- and post-operative continuous EEG (cEEG) patterns to detect abnormal cerebral activity in infants with CHD and investigate whether an association exists between the degree of encephalopathy in pre- and post-operative cEEG.MethodsThis retrospective cohort study conducted between 2010 and 2018 at a tertiary hospital in Cleveland, OH included infants with CHD with cEEG monitoring, who underwent CPB surgery within first 6 months of life.ResultsStudy included 77 patients, of which 61% were males who were operated at median age 6 days. Pre-operatively, 69% and 87% had normal cEEG and sleep-wake cycles, respectively. Post-operatively, 80% had abnormal cEEG. Longer circulatory arrest time and CPB were associated with lack of continuity (p 0.011), excessive discontinuity (p 0.007) and prolonged inter-burst interval (IBI) duration (p value < 0.001). A significant association existed between severity of encephalopathy in immediate and 24-h post-operative period (p value < 0.001).ConclusionsMore than 80% of neonates with CHD have abnormal post-operative EEG. Longer circulatory arrest time and CPB were associated with lack of continuity, excessive discontinuity, and prolonged IBI duration on post-operative EEG.ImpactThis study shows that majority of neonates with congenital heart disease (CHD) have normal pre-operative EEG with a continuous background and normal sleep-wake cycles. Also, 80% of neonates had abnormal post-operative EEG.Longer duration of arrest time and bypass time was associated with lack of continuity, excessive discontinuity, and prolonged IBI duration during post-operative EEG monitoring.These findings will help clinicians when counseling parents in the intensive care unit, risk stratification, and long-term neurodevelopmental monitoring in these high-risk patients.
引用
收藏
页码:715 / 723
页数:9
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