• AlkhatipAhmed Abdelaal Ahmed Mahmoud MAAAMMDepartment of Anaesthesia, Birmingham Children's Hospital, Birmingham, UK; Department of Anaesthesia, Beni-Suef University Hospital and Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt. Electronic addr, Mohamed Gomaa Kamel, Ehab Mohamed Farag, Mohamed Elayashy, Ahmed Farag, Hany Mahmoud Yassin, Mahmoud Hussein Bahr, Mohamed Abdelhaq, Amr Sallam, Ahmed Mostafa Kamal, EmadyMohamed Farid ElMFEDepartment of Anaesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt., Mohamed Wagih, Amr Ahmed Naguib, Mohamed Helmy, Haytham Zien Algameel, Mohamed Abdelkader, Hassan Mohamed, Mohamed Younis, Andrew Purcell, Mohamed Elramely, and Mohamed Khaled Hamza.
• Department of Anaesthesia, Birmingham Children's Hospital, Birmingham, UK; Department of Anaesthesia, Beni-Suef University Hospital and Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt. Electronic address: ahmed.alkhatip@nhs.net.
• J. Cardiothorac. Vasc. Anesth. 2021 Oct 1; 35 (10): 2875-2888.

ObjectiveCardiac surgery for repair of congenital heart defects poses unique hazards to the developing brain. Deep hypothermic circulatory arrest (DHCA) is a simple and effective method for facilitating a bloodless surgical field during congenital heart defect repair. There are, however, some concerns that prolonged DHCA increases the risk of nervous system injury. The electroencephalogram (EEG) is used in adult and, to a lesser extent, pediatric cardiac procedures as a neuromonitoring method. The present study was performed to assess outcomes following DHCA with EEG monitoring in the pediatric population.DesignIn this systematic review and meta-analysis, the PubMed, Cochrane Central Register of Controlled Trials, Scopus, Institute of Science Index, and Embase databases were searched from inception for relevant articles. A fixed- or random-effects model, as appropriate, was used.SettingSurgical setting.ParticipantsPediatric population (≤18 y old).InterventionsDHCA (18°C) with EEG monitoring.Measurements And Main ResultsNineteen articles with 1,267 pediatric patients ≤18 years were included. The event rate of clinical and EEG seizures among patients who underwent DHCA was 12.9% and 14.9%, respectively. Mortality was found to have a 6.3% prevalence. A longer duration of DHCA was associated with a higher risk of EEG seizure and neurologic abnormalities. In addition, seizures were associated with increased neurologic abnormalities and neurodevelopmental delay.ConclusionsEEG and neurologic abnormalities were common after DHCA. A longer duration of DHCA was found to lead to more EEG seizure and neurologic abnormalities. Moreover, EEG seizures were more common than clinical seizures. Seizures were found to be associated with increased neurologic abnormalities and neurodevelopmental delay.Copyright © 2021 Elsevier Inc. All rights reserved.

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