According to Dean Andropoulos, MD, and his colleagues at Texas Children’s Hospital in Houston, the group found that optimizing cerebral oxygenation in neonates undergoing cardiac surgery could lower the incidence and severity of new brain injury postoperatively, as determined by MRI.
The study examined 39 patients who underwent surgery for single- or two-ventricle lesions. The patients were examined at one year of age and cerebral oxygenation was optimized with a strategy that comprised high-flow cardiopulmonary bypass, antegrade cerebral perfusion, pH stat, hematocrit level of 30-35 percent, isoflurane up to 1 percent end-tidal, 100-400 mcg/kg of fentanyl and 0.5-2 mg/kg of midazolam.
Neurodevelopment was assessed using the Bayley Scales of Infant Development III. The researchers concluded that while neurodevelopmental outcomes are improving versus historical controls, there is still a risk of impairment in neonates that undergo cardiac surgery.
Read the Anesthesiology News report on neurodevelopmental impairment.
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