Changes in Neonatal Intraoperative Electroencephalogram Alpha: Delta Ratios Precede Neurologic Injury.
World J Pediatr Congenit Heart Surg
; : 21501351241269963, 2024 Sep 12.
Article
em En
| MEDLINE
| ID: mdl-39267395
ABSTRACT
Background:
Unrecognized intraoperative cerebral ischemia during neonatal aortic arch reconstruction may precede neurologic injury. Electroencephalogram (EEG) alphadelta ratio (AD) changes predict cerebral ischemia; however, if AD differences can identify ischemia during neonatal antegrade cerebral perfusion (ACP) and aortic arch reconstruction is unknown. We hypothesized that AD changes would precede neurologic injury.Methods:
Simultaneous EEG derived left versus right hemispheric and anterior cerebral ADs were retrospectively measured at baseline and every 5â min during arterial cannulation, cooling, ACP, and the rewarming phases of the operation. A paired left versus right AD difference >25% was considered significant for ischemia, and the duration of a significant and continuous AD difference was quantified in minutes. Neonates were divided into two groups (1) new neurologic injury (stroke or seizure) and (2) no known neurologic injury.Results:
From 72 neonates, there were no significant differences in the baseline ADs. Seven neonates (9.7%) developed a new neurologic injury (seizure = 3, stroke = 2, seizure and stroke = 2). Male gender and longer ACP times were significantly associated with neurologic injury. In neonates with a neurologic injury, the duration of a significant and continuous AD difference was longer within the hemispheric and anterior regions. Multivariable analysis demonstrated that a significant and continuous anterior AD difference (odds ratio 1.345, 95% CI 1.058-1.712; P = .01) was independently associated with neurologic injury.Conclusions:
A longer continuous anterior AD difference > 25% was independently associated with neurologic injury. Intraoperative EEG monitoring could be considered during neonatal arch reconstruction.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Idioma:
En
Revista:
World J Pediatr Congenit Heart Surg
/
World journal for pediatric & congenital heart surgery (Online)
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos
País de publicação:
Estados Unidos