• An Pediatr (Barc) · Apr 2012

    [Acute neurological complications after pediatric cardiac surgery: still a long way to go].

    • A Avila-Alvarez, I Gonzalez-Rivera, A Ferrer-Barba, F Portela-Torron, E Gonzalez-Garcia, J L Fernandez-Trisac, and C Ramil-Fraga.
    • Unidad de Neonatología, Servicio de Pediatría, Complejo Hospitalario Universitario de A Coruña, España. alexavila81@hotmail.com
    • An Pediatr (Barc). 2012 Apr 1;76(4):192-8.

    IntroductionThere has been an increasing concern over the neurological complications associated with congenital heart disease and cardiac surgery.Material And MethodsWe performed a retrospective, case-control, observational review of the postoperative period in the intensive care unit of patients undergoing cardiac surgery over the past 10 years. We selected 2 control patients for each case, matched for surgical complexity.ResultsA total of 900 patients were reviewed. We found 38 neurological complications (4.2%), of which 21 (55.3%) were in the peripheral nervous system and 17 (44.7%) in the central nervous system. The complications involving the central nervous system (1.9% of total) consisted of 8 seizures, 4 cerebrovascular accidents, 4 hypoxic-ischemic encephalopathy events, and 1 reversible neurological deficit. At the time of discharge, 35.3% were symptomatic and 17.6% had died. Patients with neurological complications had a longer bypass time (P=.009), longer aortic cross time (P=.012), longer hospitalization in intensive care (P=.001), longer duration of mechanical ventilation (P=.004) and an increased number of days under inotropic support (P=.001).ConclusionsOur incidence of neurological complications after cardiac surgery is similar to that previously described. Clinical seizures are the most common complication. Central nervous system complications are associated with a higher morbidity and hospitalization time. Units caring for patients with congenital heart disease must implement neurological monitoring during and after cardiac surgery to prevent and to detect these complications earlier.Copyright © 2011 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

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