Neurological Outcome of Children with Abnormal Head Imaging Undergoing Cardiac Surgery on Cardiopulmonary Bypass

Abstract

Abstract Background Neurodevelopmental disability in congenital heart disease (CHD) is concerning, with potential neurological issues arising during or post-surgery. This study explores the relationship between pre-surgery abnormal brain findings and post-surgical neurological outcomes in CHD children. Methods A retrospective study included pediatric cardiac intensive care unit patients with abnormal preoperative head imaging. A control group was established using a one-to-one matching approach, considering age, cardiac lesion, and type of surgery as criteria. Data encompassed demographics, cardiac lesions, surgical details, imaging findings, and neurological outcomes. Results During the study period, 19 patients with abnormal preoperative head imaging were identified. No notable distinctions were observed in terms of illness severity between study and control groups. The study group demonstrated a statistically significant increase in the length of hospitalization, a prolonged duration for the initiation of oral feeds and the attainment of complete oral feeds. Pre and Post-operative Glasgow Coma Scale (GCS), Pediatric Cerebral Performance Category (PCPC), and Pediatric Stroke Outcome Measure (PSOM) scores exhibited greater impairment in the study group. However, no significant differences were observed in the time required to return to baseline GCS or the magnitude of change in PCPC and PSOM scores between preoperative and postoperative assessments. Conclusion Pediatric patients with abnormal head imaging experience prolonged hospitalization after cardiac surgery on bypass. The surgical procedure may have a minor influence on their short-term neurological status. Further investigation is needed to understand the implications of abnormal head imaging in these patients.