| Perioperative amplitude-integrated EEG and neurodevelopment in infants with congenital heart disease. | |
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MedLine Citation:
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PMID: 22653373 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: Perioperative brain injury is common in young infants undergoing cardiac surgery. We aimed to determine the relationship between perioperative electrical seizures, the background pattern of amplitude-integrated electroencephalography (aEEG) and 2-year neurodevelopmental outcome in young infants undergoing surgery for congenital heart disease. METHODS: A total of 150 newborn infants undergoing cardiac surgery underwent aEEG monitoring prior to and during surgery, and for 72 h postoperatively. Two blinded assessors reviewed the aEEGs for seizure activity and background pattern. Survivors underwent neurodevelopmental outcome assessment using the Bayley Scales of Infant Development (3rd edn.) at 2 years. RESULTS: The median age at surgery was 7 days (IQR 4-11). Cardiopulmonary bypass was used in 83 %. Perioperative electrical seizures occurred in 30 %, of whom 1/4 had a clinical correlate, but were not associated with 2-year outcome. Recovery to a continuous background occurred at a median 6 (3-13) h and sleep-wake cycling recovered at 21 (14-30) h. Prolonged aEEG recovery was associated with increased mortality and worse neurodevelopmental outcome. Failure of the aEEG to recover to a continuous background by 48 postoperative hours was associated with impairment in all outcome domains (p < 0.05). Continued abnormal aEEG at 7 postoperative days was highly associated with mortality (p < 0.001). CONCLUSIONS: Perioperative seizures were common in this cohort of infants but did not impact on 2-year neurodevelopmental outcome. Delayed recovery in aEEG background was associated with increased risk of early mortality and worse neurodevelopment. Ongoing monitoring of the survivors is essential to determine the longer-term significance of these findings. |
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Authors:
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Julia K Gunn; John Beca; Rodney W Hunt; Monika Olischar; Lara S Shekerdemian |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-6-1 |
Journal Detail:
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Title: Intensive care medicine Volume: - ISSN: 1432-1238 ISO Abbreviation: - Publication Date: 2012 Jun |
Date Detail:
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Created Date: 2012-6-1 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Neonatal Medicine, Royal Children's Hospital, Melbourne, Australia, julia.gunn@mcri.edu.au. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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