Clark Joseph B, Barnes Mollie L, Undar Akif, Myers John L
Department of Pediatrics, Penn State Hershey, Hershey, PA, USA.
World J Pediatr Congenit Heart Surg. 2012 Jan 1;3(1):87-95. doi: 10.1177/2150135111418257.
Brain injury remains a source of morbidity associated with congenital heart surgery. Intraoperative neuromonitoring is used by many centers to help minimize neurologic injury and improve outcomes. Neuromonitoring at our institution is performed using a combination of near-infrared spectroscopy, transcranial Doppler ultrasound, electroencephalography, and somatosensory evoked potentials. Adverse or concerning parameters instigate attempts at corrective intervention. A review of the literature regarding neuromonitoring studies in pediatric cardiac surgery shows that evidence is limited to demonstrate that intraoperative neuromonitoring is associated with improved neurologic outcomes. Further clinical research is needed to assess the utility and cost-effectiveness of intraoperative neuromonitoring for pediatric heart surgery.
脑损伤仍然是先天性心脏手术相关的发病原因之一。许多中心采用术中神经监测来尽量减少神经损伤并改善预后。我们机构的神经监测是通过近红外光谱、经颅多普勒超声、脑电图和体感诱发电位相结合的方式进行的。不良或令人担忧的参数会促使进行纠正干预。对有关小儿心脏手术神经监测研究的文献综述表明，证据有限，无法证明术中神经监测与改善神经预后相关。需要进一步的临床研究来评估小儿心脏手术术中神经监测的效用和成本效益。
