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Early post-operative neurodevelopment and visual assessment in neonates with congenital heart disease undergoing cardiac surgery

Journal of Perinatology volume 43, pages 856–863 (2023)Cite this article

Subjects

Abstract

Objective

Assessment of neurobehavior and visual function of newborns with congenital heart disease during the post-operative period to identify infants at risk of neurodevelopmental and visual impairment.

Study design

Prospective study that included 45 newborns who underwent cardiac surgery. Newborn Behavioral Observations test (NBO) and “ML Battery of Optotypes” were used for assessment.

Results

The median NBO global score was 2.4 [2.1–2.6]. Total days of oral morphine [p = 0.005] and total days of sedation [p = 0.009] were strongly related to abnormal evaluations. Time of cerebral regional oxygen saturation (CrSO2) under 40% during surgery and increased lactate were related to abnormal motor evaluation. Only 14.5% of patients presented pathological results in visual evaluation.

Conclusions

We have demonstrated alterations in attention, autonomic, motor, and oral motor function. Duration of sedative medication, time of CrSO2 under 40% during surgery, and increased lactate are the most important risk factors. No significant visual impairment was detected.

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Fig. 1: Patient Flow Chart.
Fig. 2: Main NBO Results.
Fig. 3: Main ML Optotype Results.

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Data availability

All relevant data are included in the manuscript. Data are available on reasonable request.

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Acknowledgements

The authors would like to acknowledge support from the Neonatal Intensive Care Unit nurses and physicians at Hospital Sant Joan de Déu and the Cardiovascular Surgery Team.

Funding

This work was supported by a private grant from Godia and by a grant from Instituto Carlos III [PFIS17-144]. It was also partly supported by Fundació La Marató de TV3-Ref 202016-30-31. The sponsors were not involved in the collection, analysis, or interpretation of the data.

Author information

Author notes

  1. These authors contributed equally: M. Camprubí-Camprubí, J. Sanchez-de-Toledo.

Authors and Affiliations

  1. BCNatal, Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clinic, University of Barcelona, Barcelona, Spain

    D. Cañizo-Vazquez, M. Leonhardt & M. Camprubí-Camprubí

  2. Department of Pediatrics, Boston Children’s Hospital, Boston, MA, USA

    S. Hadley

  3. Cardiovascular Research Group, Sant Joan de Déu Research Institute, Barcelona, Spain

    M. Camprubí-Camprubí & J. Sanchez-de-Toledo

  4. Pediatric Cardiology Department. Sant Joan de Déu Hospital, Barcelona, Spain

    J. Sanchez-de-Toledo

  5. Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA

    J. Sanchez-de-Toledo

Authors
  1. D. Cañizo-Vazquez
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  2. S. Hadley
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  3. M. Leonhardt
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  4. M. Camprubí-Camprubí
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  5. J. Sanchez-de-Toledo
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Contributions

DCV, SH, and MCC designed and conceptualized the study, played a major role in the acquisition of data, and vouched for the study’s accuracy and completeness. They drafted the manuscript for intellectual content of the manuscript. ML played a major role in the acquisition of data. JSDT and MCC contributed to the design of the study and participated in drafting the manuscript. All the authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to M. Camprubí-Camprubí.

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Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

This study protocol was reviewed and approved by Clinical Research Ethics Board of Hospital Sant Joan de Déu, approval number [PIC 120-17] and was performed in accordance with the Declaration of Helsinki. Written informed consent was obtained from the parents or legal guardians of all participants.

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Cañizo-Vazquez, D., Hadley, S., Leonhardt, M. et al. Early post-operative neurodevelopment and visual assessment in neonates with congenital heart disease undergoing cardiac surgery. J Perinatol 43, 856–863 (2023). https://doi.org/10.1038/s41372-022-01555-7

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