Predictors of Neurologic Complications and Neurodevelopmental Outcome in Pediatric Cardiac Surgery With Extracorporeal Membrane Oxygenation.

Peter Pastuszko, Michael G Katz, Shana Ravvin, Tain-Yen Hsia, G Praveen Raju, Vishal Nigam, Richard D Mainwaring
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Abstract

Extracorporeal membrane oxygenation (ECMO) has emerged as an important intervention for children both preceding and following cardiac surgery. There is a notable lack of comprehensive information regarding neurodevelopmental outcomes. The Norwood procedure and complex biventricular repairs exhibit the highest prevalence of ECMO usage. Examination of the data demonstrates that only 50% of ECMO survivors achieved normative cognitive outcomes, with 40% of those experiencing long-term neurological deficits. It is imperative to conduct robustly designed studies with extended follow-up periods to establish guidelines for neuromonitoring and neuroprotection during ECMO in the field of congenital cardiac surgery.

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体外膜氧合小儿心脏手术中神经系统并发症和神经发育结果的预测因素
体外膜肺氧合(ECMO)已成为儿童心脏手术前后的一项重要干预措施。有关神经发育结果的综合信息明显不足。诺伍德手术和复杂的双心室修补术使用 ECMO 的比例最高。研究数据表明,只有 50% 的 ECMO 存活者达到了正常的认知结果,其中 40% 的存活者出现了长期的神经功能缺损。当务之急是开展设计严谨、随访时间较长的研究,为先天性心脏手术 ECMO 期间的神经监测和神经保护制定指导方针。
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