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Quantitative EEG before and after open heart surgery in children. A significant decrease in the beta and alpha 2
E Hauser1, R Seidl, D Rohrbach
1Department of Pediatrics, University of Vienna, Austria.
Insights
Quantitative EEGs reveal transient brain changes after open heart surgery in children. Most children showed temporary EEG alterations, indicating a mild, short-lived organic brain syndrome post-operation.
Area of Science:
- Neuroscience
- Pediatric Cardiology
- Clinical Neurophysiology
Background:
- Open heart surgery in children can potentially impact neurological function.
- Understanding postoperative neurological changes is crucial for patient recovery.
- Quantitative electroencephalography (qEEG) offers a method to assess brain activity objectively.
Purpose of the Study:
- To investigate the utility of quantitative EEGs (qEEGs) in detecting postoperative cerebral changes in children following open heart surgery.
- To characterize the temporal patterns of EEG alterations in the early and later postoperative periods.
Main Methods:
- Quantitative EEG recordings were obtained from 30 pediatric patients before, and at 6, 11, and 44 days after open heart surgery.
- EEG data were analyzed for changes in various frequency bands (delta, alpha 2, beta).
- Clinical neurological assessments and plasma electrolyte levels (sodium, chloride) were also monitored.
Main Results:
- No new neurological signs of cerebral involvement were observed in 28 out of 30 children.
- A significant decrease in beta and alpha 2 EEG bands was noted 6 and 11 days postoperatively.
- An increase in the delta band was prominent at 6 days, with most EEG variables returning to baseline by 44 days.
- Despite electrolyte fluctuations, EEG changes correlated with postoperative outcomes, suggesting a general, mild organic brain syndrome.
Conclusions:
- Quantitative EEGs can detect transient, usually mild, neurological alterations following open heart surgery in children.
- These EEG changes indicate a common, short-lived organic brain syndrome after the procedure.
- EEG monitoring may aid in assessing neurological recovery in pediatric cardiac surgical patients.
Abstract:
Quantitative EEGs of 30 patients undergoing open heart surgery were investigated before, 6 days, 11 days and 44 days after operation. The study was conducted in order to investigate whether quantitative EEGs can show postoperative changes in children after open heart surgery. In 28 children, no new neurological signs of cerebral involvement were seen postoperatively. The most striking feature in these children was a significant decrease in the beta and the alpha 2 bands 6 and 11 days postoperatively. The pattern in the delta band was dominated by an increase 6 days postoperatively. Except for a slight decrease in alpha 2 waves, all variables were restored to preoperative values at 44 days after the operation. We found a significant decrease in plasma sodium and chloride after surgery but children with no or slight declines (1-3 mmol/l) also showed increased slow activity postoperatively. Therefore we conclude that an organic brain syndrome, although usually mild and transient, is a general phenomenon after open heart surgery.