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Published on: June 21, 2024
Effect of perioperative amplitude-integrated electroencephalography on neurodevelopmental outcomes following infant
Juan Gui1,2, Suixin Liang2, Yunxia Sun2
1The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China.
Insights
Amplitude-integrated electroencephalography (aEEG) monitoring can predict neurodevelopmental outcomes in infants with congenital heart disease (CHD) after early surgery. Abnormal aEEG patterns indicate a higher risk for delayed motor and cognitive development.
Area of Science:
- Pediatric Cardiology
- Neurodevelopmental Pediatrics
- Clinical Neurophysiology
Background:
- Congenital heart disease (CHD) affects neurodevelopmental outcomes in infants.
- Early cardiac surgery is common for infants with CHD.
- Predictive tools for neurodevelopmental outcomes are crucial.
Purpose of the Study:
- To evaluate the impact of perioperative amplitude-integrated electroencephalography (aEEG) on neurodevelopmental outcomes in infants with CHD.
- To identify predictors of neurodevelopmental delay in this population.
Main Methods:
- Prospective study of 93 infants with CHD undergoing cardiac surgery before 3 months of age.
- Perioperative aEEG monitoring (pre- and postoperative).
- Neurodevelopmental assessment at 1 year using Bayley Scales of Infant Test.
Main Results:
- Most infants showed continuous normal voltage (CNV) on aEEG (82.2% preoperatively, 93.7% postoperatively).
- Seizures were rare (2/93 preoperatively, 3/93 postoperatively).
- Abnormal preoperative aEEG and absent postoperative SWC independently predicted poorer motor and cognitive outcomes at 1 year.
Conclusions:
- Infants with CHD undergoing early surgery exhibit delayed neurodevelopmental outcomes.
- Perioperative aEEG is a valuable tool for predicting neurodevelopmental outcomes in infants with CHD.
- Cyanotic CHD, longer ICU stay, and behavioral problems are associated with poorer outcomes.
Abstract:
The purpose of the current study was to determine the effect of perioperative amplitude-integrated electroencephalography (aEEG) on neurodevelopmental outcomes in infants with congenital heart disease (CHD). A total of 93 children with CHD were included in the current study. All patients enrolled in the present study had undergone cardiac surgery prior to 3 months of age and pre- or postoperative aEEG was monitored. Participants were assessed after 1 year using the Bayley Scales of Infant Test. A total of 82.2% of infants exhibited continuous normal voltage preoperatively (CNV) and 93.7% exhibited CNV postoperatively. Seizures were indicated in 2 infants preoperatively and 3 infants postoperatively. Compared with infants with PDI, infants with cyanotic CHD (β=17.218) exhibited a significantly lower MDI, an increased length of intensive care stay, and lower PDI scores (β=-0.577). Infants that underwent surgery with CPB exhibited higher PDI scores (β=11.956). Infants that exhibited behavioral problems also had lower PDI scores (β=-10.605). An abnormal preoperative background pattern and an absent postoperative SWC independently predicted poorer motor (P=0.014) and cognitive (P=0.049) outcomes at 1 year. The current study demonstrated that infants with CHD who underwent cardiac surgery prior to 3 months of age exhibited delayed neurodevelopmental outcomes, and that an aEEG assessment can aid in predicting these outcomes following surgery.
