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Neurologic Injury in Neonates Undergoing Cardiac Surgery
Dean B Andropoulos1, Ronald Blaine Easley1, Erin A Gottlieb2
1Department of Pediatric Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, Houston, TX, USA; Departments of Anesthesiology and Pediatrics, Baylor College of Medicine, 6551 Main St. E 1940, Houston, TX 77030-3411, USA.
Clinics in Perinatology
|October 27, 2019
Summary
Brain injury before and after neonatal heart surgery impacts neurodevelopment. Further research is needed to detect, prevent, and treat this brain injury to improve long-term outcomes.
Area of Science:
- Neonatal neuroscience
- Pediatric cardiology
- Neuroimaging
Background:
- Neonatal congenital heart surgery (CHS) is associated with significant risks.
- Neurodevelopmental outcomes in infants undergoing CHS are a major concern.
- Brain injury, detectable by magnetic resonance imaging (MRI), is a key factor affecting these outcomes.
Purpose of the Study:
- To highlight the influence of brain injury on neurodevelopmental outcomes post-neonatal CHS.
- To emphasize that brain injury can occur prenatally and postnatally, preceding cardiac surgery.
- To underscore the need for improved strategies for managing neonatal brain injury.
Main Methods:
- Utilizes magnetic resonance imaging (MRI) techniques to detect brain injury.
- Analyzes the timing of brain injury in relation to cardiac surgery (prenatal and postnatal periods).
- Reviews existing literature on neurodevelopmental outcomes and brain injury in neonates with CHS.
Main Results:
- Brain injury is a significant predictor of neurodevelopmental outcomes in neonates undergoing CHS.
- New brain injuries are frequently detected by MRI after cardiac surgery.
- Brain injury is not solely a consequence of surgery but can originate prenatally and in the early postnatal period.
Conclusions:
- Optimizing neurodevelopmental outcomes requires addressing brain injury in the neonatal period.
- Effective strategies for the detection, prevention, and treatment of neonatal brain injury are crucial.
- Further research is essential to develop and implement these strategies to mitigate the impact of brain injury on long-term neurodevelopmental trajectories.
