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Monitoring the brain before, during, and after cardiac surgery to improve long-term neurodevelopmental outcomes

Published online by Cambridge University Press:  13 October 2006

Nancy S. Ghanayem
Affiliation:
Department of Pediatrics, Medical College of Wisconsin, Wisconsin, United States of America Division of Critical Care, Medical College of Wisconsin, Wisconsin, United States of America Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
Michael E. Mitchell
Affiliation:
Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, Wisconsin, United States of America Herma Heart Center at Children's Hospital of Wisconsin, Wisconsin, United States of America Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
James S. Tweddell
Affiliation:
Department of Surgery, Division of Cardiothoracic Surgery, Medical College of Wisconsin, Wisconsin, United States of America Herma Heart Center at Children's Hospital of Wisconsin, Wisconsin, United States of America Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
George M. Hoffman
Affiliation:
Division of Critical Care, Medical College of Wisconsin, Wisconsin, United States of America Department of Anesthesia, Medical College of Wisconsin, Wisconsin, United States of America Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America

Abstract

Innovation in surgical and medical management of cardiac disease has generated a dramatic improvement in operative survival. Along with these favourable results in terms of survival is the heightened awareness of neurologic complications, which often become evident beyond the early postoperative period. A large, multicentre prospective study found serious neurologic injury occurs in about one-twentieth of patients after myocardial revascularization in adults.1 More subtle evidence of persistent cognitive decline and functional impairment has been shown to occur in over two-fifths of such patients.2 Acute neurologic abnormalities are reported in up to one-fifth of infants and children who undergo cardiac surgery.36 Lasting impairments in cognitive, motor, and expressive functioning have been reported in up to three-fifths of children who have undergone complex cardiac surgery during infancy.7 Specifically, gross and fine motor delays, visual-spatial problems, language deficits and long-term emotional and behavioural problems have been found.813

Type
Long-term Outcomes
Copyright
© 2006 Cambridge University Press

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