Abstract:
:Long-term neurodevelopmental sequelae are commonly detectable in children after open-heart surgery with cardiopulmonary bypass (CPB). The objective of the study was to determine the neurodevelopmental outcome in these children in relation to postoperative inflammatory reaction. This is a prospective, observational study on children with congenital heart defects (n = 32) undergoing elective open-heart surgery in a tertiary pediatric cardiac center. Neurodevelopmental outcome was assessed in the median 6 months after CPB. Neurological examination was done in all children before the operation and, additionally, complete neurodevelopmental status was assessed preoperatively in 14 children. Three hours after the end of CPB, plasma concentrations of interleukin (IL)-6 and IL-8 were strongly elevated (p < 0.001). Moreover, there was a rise of neutrophils and C-reactive protein at 24 h postoperatively (p < 0.001). Intellectual performance after surgery was correlated with preoperative performance, r ( S ) = 0.83, p < 0.001 (mean IQ scores after CPB = 90.4 +/- 18.4 and before CPB = 87.5 +/- 14.5, p = 0.20). Multiple regression analysis demonstrated that preoperative IQ scores accounted for 83.8% of the variance of postoperative IQ scores (p < 0.0001). Inflammatory variables were not significant predictors of postoperative IQ scores. The frequency of neuromotor abnormalities at 6 months after CPB was influenced by the presence of a cyanotic heart defect, duration of CPB and aortic clamp time, and plasma levels of IL-6 shortly after CPB (R (2) = 67.8%, p = 0.002). In conclusion, in the examined population, preexisting neurodevelopmental impairment is frequent and predicts postoperative outcome. The high frequency of postoperative neuromotor disabilities seems to be associated with the type of congenital heart defect but also with the procedure and possible complications of CPB.
journal_name
Pediatr Cardioljournal_title
Pediatric cardiologyauthors
Gessler P,Schmitt B,Prètre R,Latal Bdoi
10.1007/s00246-008-9354-5subject
Has Abstractpub_date
2009-04-01 00:00:00pages
301-5issue
3eissn
0172-0643issn
1432-1971journal_volume
30pub_type
杂志文章abstract:BACKGROUND:This study applied tissue Doppler imaging and color tissue Doppler imaging to study atrial function changes in patients with hypertrophic cardiomyopathy (HCM). The profile of the segmental atrial velocities and the strain rate were determined and compared with those of normal matched control subjects. METHO...
journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-007-9112-0
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abstract::To determine the influence of heart rate (HR) on systolic time intervals (STI) in neonates, serial measurements of right ventricular (RVSTI) and left ventricular systolic time intervals (LVSTI) were made on 30 healthy term newborn infants at age 4-8 h, 24-30 h, eight days, and four weeks. STI was related to HR and age...
journal_title:Pediatric cardiology
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journal_title:Pediatric cardiology
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journal_title:Pediatric cardiology
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journal_title:Pediatric cardiology
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journal_title:Pediatric cardiology
pub_type: 杂志文章,评审
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journal_title:Pediatric cardiology
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journal_title:Pediatric cardiology
pub_type: 杂志文章
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更新日期:1989-01-01 00:00:00
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journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/BF02281003
更新日期:1983-01-01 00:00:00
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journal_title:Pediatric cardiology
pub_type: 杂志文章,多中心研究
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更新日期:2013-02-01 00:00:00
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journal_title:Pediatric cardiology
pub_type: 杂志文章
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journal_title:Pediatric cardiology
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更新日期:2013-08-01 00:00:00
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journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s00246-012-0526-y
更新日期:2013-03-01 00:00:00
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journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/BF02315475
更新日期:1986-01-01 00:00:00
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journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s002469900124
更新日期:1997-03-01 00:00:00
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journal_title:Pediatric cardiology
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journal_title:Pediatric cardiology
pub_type: 杂志文章
doi:10.1007/s002460010188
更新日期:2001-03-01 00:00:00
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journal_title:Pediatric cardiology
pub_type: 杂志文章,评审
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pub_type: 临床试验,杂志文章
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更新日期:2009-02-01 00:00:00
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journal_title:Pediatric cardiology
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更新日期:2014-08-01 00:00:00
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journal_title:Pediatric cardiology
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journal_title:Pediatric cardiology
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doi:10.1007/BF00796320
更新日期:1994-05-01 00:00:00
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journal_title:Pediatric cardiology
pub_type: 杂志文章
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更新日期:2005-09-01 00:00:00
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journal_title:Pediatric cardiology
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journal_title:Pediatric cardiology
pub_type: 杂志文章
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更新日期:2006-03-01 00:00:00
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pub_type: 杂志文章
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更新日期:2005-07-01 00:00:00