Belfi Alexandra, Vega Laia, Aguar Marta, Carmen Bravo María, Cañizo Débora, Díaz Rueda Laura, Camprubí-Camprubí Marta
Vanderbilt University School of Medicine, Vanderbilt University, Nashville, United States.
Unidad de cuidados intensivos pediátricos y neonatales, Hospital Universitari Dexeus, Grupo Quiron Salud, Barcelona, Spain.
An Pediatr (Engl Ed). 2025 Feb;102(2):503739. doi: 10.1016/j.anpede.2025.503739. Epub 2025 Feb 13.
There is evidence of the high incidence of neurological abnormalities in patients with congenital heart disease (CHD). Despite this, perioperative neuromonitoring strategies and long-term follow-up protocols are not standardized in Spain.
The aim of our study was to describe current clinical practice in neuromonitoring, neuroimaging and neurodevelopmental follow-up in patients with CHD in Spanish hospitals that perform paediatric cardiac surgery (PCS).
We conducted a survey by adapting a questionnaire originally developed by the European Association Brain and Congenital Heart Disease Consortium to collect data on aspects such as the implementation of perioperative neuromonitoring and the type of neuroimaging techniques and neurological follow-up performed. The questionnaire was distributed to the 19 Spanish hospitals that perform PCS.
We received responses from 17 centres. Eighty-eight percent performed some type of preoperative neuroimaging and 81% postoperative monitoring. The most widely used technique was transfontanellar sonography. Fifty-six percent of the centres used some form of intraoperative neuromonitoring, most frequently near-infrared spectroscopy. Nineteen percent had an established protocol for the follow-up of these patients and 13% were in the process of developing it.
There is considerable heterogeneity in neuromonitoring, neuroimaging and neurologic follow-up practices in the management of patients with CHD in hospitals that perform PCS in Spain. These findings highlight the need to pursue a consensus in order to standardise neuromonitoring and neurologic follow-up strategies in children with CHD in Spain.
有证据表明先天性心脏病（CHD）患者神经功能异常的发生率很高。尽管如此，西班牙围手术期神经监测策略和长期随访方案尚未标准化。
我们研究的目的是描述西班牙进行小儿心脏手术（PCS）的医院中，CHD患者在神经监测、神经影像学和神经发育随访方面的当前临床实践。
我们通过改编欧洲脑与先天性心脏病协会联盟最初制定的问卷进行了一项调查，以收集围手术期神经监测的实施、神经影像学技术类型以及所进行的神经学随访等方面的数据。该问卷分发给了西班牙19家进行PCS的医院。
我们收到了17个中心的回复。88%的中心进行了某种类型的术前神经影像学检查，81%进行了术后监测。使用最广泛的技术是经囟门超声检查。56%的中心使用了某种形式的术中神经监测，最常用的是近红外光谱法。19%的中心有针对这些患者的既定随访方案，13%正在制定该方案。
在西班牙进行PCS的医院中，CHD患者管理中的神经监测、神经影像学和神经学随访实践存在相当大的异质性。这些发现凸显了在西班牙就CHD患儿的神经监测和神经学随访策略达成共识以实现标准化的必要性。
