Neuromonitoring practices for neonates with congenital heart disease: a scoping review.

Autor: Pardo AC; Department of Pediatrics (Neurology and Epilepsy). Northwestern University Feinberg School of Medicine, Chicago, IL, US. Andrea.pardo@northwestern.edu., Carrasco M; Department of Neurology. University of Wisconsin School of Medicine and Public Health, Madison, WI, US., Wintermark P; Department of Pediatrics, Faculty of Medicine and Health Sciences, McGill University, Montreal, Qc, Canada., Nunes D; Galter Health Sciences Library. Northwestern University Feinberg School of Medicine, Chicago, IL, US., Chock VY; Department of Pediatrics (Neonatology), Lucile Packard Children's Hospital and Stanford University, Palo Alto, CA, US., Sen S; Department of Pediatrics (Neonatology). Northwestern University Feinberg School of Medicine, Chicago, IL, US.; Department of Pediatrics, University of California Irvine, Orange, CA, US., Wusthoff CJ; Department of Neurology, Stanford University, Palo Alto, CA, US.
Jazyk: angličtina
Zdroj: Pediatric research [Pediatr Res] 2024 Aug 25. Date of Electronic Publication: 2024 Aug 25.
DOI: 10.1038/s41390-024-03484-x
Abstrakt: Neonates with congenital heart disease (CHD) are at risk for adverse neurodevelopmental outcomes. This scoping review summarizes neuromonitoring methods in neonates with CHD. We identified 84 studies investigating the use of near-infrared spectroscopy (NIRS) (n = 37), electroencephalography (EEG) (n = 20), amplitude-integrated electroencephalography (aEEG) (n = 10), transcranial Doppler sonography (TCD) (n = 6), and multimodal monitoring (n = 11). NIRS was used to evaluate cerebral oxygenation, identify risk thresholds and adverse events in the intensive care unit (ICU), and outcomes. EEG was utilized to screen for seizures and to predict adverse outcomes. Studies of aEEG have focused on characterizing background patterns, detecting seizures, and outcomes. Studies of TCD have focused on correlation with short-term clinical outcomes. Multimodal monitoring studies characterized cerebral physiologic dynamics. Most of the studies were performed in single centers, had a limited number of neonates (range 3-183), demonstrated variability in neuromonitoring practices, and lacked standardized approaches to neurodevelopmental testing. We identified areas of improvement for future research: (1) large multicenter studies to evaluate developmental correlates of neuromonitoring practices; (2) guidelines to standardize neurodevelopmental testing methodologies; (3) research to address geographic variation in resource utilization; (4) integration and synchronization of multimodal monitoring; and (5) research to establish a standardized framework for neuromonitoring techniques across diverse settings. IMPACT: This scoping review summarizes the literature regarding neuromonitoring practices in neonates with congenital heart disease (CHD). The identification of low cerebral oxygenation thresholds with NIRS may be used to identify neonates at risk for adverse events in the ICU or adverse neurodevelopmental outcomes. Postoperative neuromonitoring with continuous EEG screening for subclinical seizures and status epilepticus, allow for early and appropriate therapy. Future studies should focus on enrolling larger multicenter cohorts of neonates with CHD with a standardized framework of neuromonitoring practices in this population. Postoperative neurodevelopmental testing should utilize standard assessments and testing intervals.
(© 2024. The Author(s).)
Databáze: MEDLINE
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