Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, Guangdong, 510100, China.
Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, Guangdong, 510100, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.
Biomed Pharmacother. 2020 Dec;132:110957. doi: 10.1016/j.biopha.2020.110957. Epub 2020 Nov 1.
Congenital heart disease, particularly cyanotic congenital heart disease (CCHD), may lead to a neurodevelopmental delay through central nervous system injury, more unstable central nervous system development, and increased vulnerability of the nervous system. Neurodevelopmental disease is the most serious disorder of childhood, affecting the quality of life of children and their families. Therefore, the monitoring and optimization of nerve damage treatments are important. The factors contributing to neurodevelopmental disease are primarily related to preoperative, intraoperative, postoperative, genetic, and environmental causes, with intraoperative causes being the most influential. Nevertheless, few studies have examined these factors, particularly the influencing factors during early postoperative care. Children with congenital heart disease may experience brain damage during early heart intensive care due to unstable haemodynamics and total body oxygen transfer, particularly early postoperative inflammatory reactions in the brain, blood glucose levels, and other factors that potentially influence long-term neural development. This study analyses the forms of structural and functional brain damage in the early postoperative period, along with the recent evolution of research on its contributing factors.
先天性心脏病,特别是发绀型先天性心脏病(CCHD),可能通过中枢神经系统损伤、更不稳定的中枢神经系统发育和增加的神经系统易损性导致神经发育迟缓。神经发育疾病是儿童中最严重的疾病,影响儿童及其家庭的生活质量。因此,监测和优化神经损伤治疗非常重要。导致神经发育疾病的因素主要与术前、术中、术后、遗传和环境因素有关,术中因素的影响最大。然而,很少有研究探讨这些因素,特别是在术后早期护理期间的影响因素。由于血流动力学不稳定和全身氧传递,患有先天性心脏病的儿童在心脏重症监护的早期可能会出现脑损伤,特别是术后早期大脑的炎症反应、血糖水平和其他可能影响长期神经发育的因素。本研究分析了术后早期的结构性和功能性脑损伤形式,以及对其相关因素的最新研究进展。