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Chapter 13 - Perioperative Monitoring for Congenital Heart Disease Surgery

from Part IV - Practice of Neuromonitoring: Cardiac Intensive Care Unit

Published online by Cambridge University Press:  08 September 2022

By
Shavonne L. Massey  and
Robert Clancy
Edited by
Cecil D. Hahn  and
Courtney J. Wusthoff
Cecil D. Hahn
Affiliation:
The Hospital for Sick Children, University of Toronto
Courtney J. Wusthoff
Affiliation:
Lucile Packard Children’s Hospital, Stanford University
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Summary

Congenital heart disease (CHD) encompasses a large collection of cardiac malformations discovered at or before birth. CHD has an incidence of 4 – 50/1000 live births annually. One quarter of these require surgery shortly after birth. Newborn heart surgery has substantially changed since the modern era began with the adaptation of adult cardiopulmonary bypass (CPB) circuitry for infants. After decades of progress, the center of focus has now shifted from survival to the quality of life following newborn heart surgery (NBHS). Indeed, neurodevelopmental disabilities are now considered the single most common sequela of NBHS. Clinical management in the peri-operative period has a significant impact on the infants’ long-term outcomes. Consequently, neurological monitoring in the congenital heart disease population is increasing worldwide. With so many infants undergoing NBHS, the field of neuromonitoring for these patients is wide. In this chapter, we first review the neurological effects of hypothermia and the actual conduct of newborn heart surgery. We then discuss the indications for neuromonitoring and summarize its findings and outcomes in this unique population.

Keywords

Congenital heart disease (CHD)cardiac intensive carecardiac bypassEEGnewborn heart surgery (NBHS)hypothermiaprognosisseizures
Type
Chapter
Information
Neuromonitoring in Neonatal and Pediatric Critical Care , pp. 165 - 180
Publisher: Cambridge University Press
Print publication year: 2022

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