医学
深低温停循环
脑电图
人口
心脏外科
突发抑制
麻醉
围手术期
麻醉学
体外循环
随机对照试验
重症监护医学
科克伦图书馆
梅德林
重症监护室
置信区间
体外膜肺氧合
体温过低
重症监护
作者
Ahmed Abdelaal Ahmed Mahmoud M Alkhatip,Mohamed Gomaa Kamel,Ehab Farag,Mohamed Elayashy,Ahmed A. Farag,Hany Mahmoud Yassin,Mahmoud Hussein Bahr,Mohamed Mohamed Abdelhaq,Amr Sallam,Ahmed M Kamal,Mohamed Farid El Emady,Mohamed Wagih,Amr Naguib,Mohamed Helmy,Haytham Zien Algameel,Mohamed Abdelkader,Hassan Mohamed,Mohamed Younis,Andrew Purcell,Mohamed Adly Elramely,Mohamed Hamza
标识
DOI:10.1053/j.jvca.2021.01.039
摘要
Cardiac 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.In 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.Surgical setting.Pediatric population (≤18 y old).DHCA (18°C) with EEG monitoring.Nineteen 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.EEG 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.
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