Cañizo-Vazquez D, Hadley S, Leonhardt M, Camprubí-Camprubí M, Sanchez-de-Toledo J
BCNatal, Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clinic, University of Barcelona, Barcelona, Spain.
Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA.
J Perinatol. 2023 Jul;43(7):856-863. doi: 10.1038/s41372-022-01555-7. Epub 2022 Nov 8.
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.
Prospective study that included 45 newborns who underwent cardiac surgery. Newborn Behavioral Observations test (NBO) and "ML Battery of Optotypes" were used for assessment.
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 (CrSO) under 40% during surgery and increased lactate were related to abnormal motor evaluation. Only 14.5% of patients presented pathological results in visual evaluation.
We have demonstrated alterations in attention, autonomic, motor, and oral motor function. Duration of sedative medication, time of CrSO under 40% during surgery, and increased lactate are the most important risk factors. No significant visual impairment was detected.
评估先天性心脏病新生儿术后的神经行为和视觉功能，以确定有神经发育和视觉损害风险的婴儿。
前瞻性研究，纳入45例接受心脏手术的新生儿。采用新生儿行为观察测试（NBO）和“ML视力表组”进行评估。
NBO总体评分中位数为2.4[2.1 - 2.6]。口服吗啡总天数[p = 0.005]和镇静总天数[p = 0.009]与异常评估密切相关。手术期间脑局部血氧饱和度（CrSO）低于40%的时间和乳酸升高与运动评估异常有关。仅14.5%的患者在视觉评估中呈现病理结果。
我们已证明注意力、自主神经、运动和口腔运动功能存在改变。镇静药物使用时间、手术期间CrSO低于40%的时间以及乳酸升高是最重要的危险因素。未检测到明显的视觉损害。
