The pursuit of effective neuroprotection during infant cardiac surgery.
Advances in infant cardiac surgery have resulted in a dramatic decline in mortality rates; however, neurological morbidity remains an important concern. The effectiveness of a number of interventional strategies to prevent or minimize brain injury during open heart surgery are currently being investigated. This article provides an overview of two approaches: (1) interventions to enhance intraoperative cerebral oxygenation so as to prevent hypoxic-ischemic insults, and (2) the application of cerebral rescue therapies to attenuate the cascade of brain injury. Infant cardiac surgery provides a controlled environment in which to apply these neuroprotective approaches, so as to optimize the quality of life of these vulnerable children.
du Plessis
A J
AJ
Department of Neurology, Children's Hospital, Boston, MA 02115, USA.
Johnston
M V
MV
D000137:Acid-Base Imbalance / Q000209:etiology / Q000517:prevention & control; D001930:Brain Injuries / Q000209:etiology / Q000517:prevention & control; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000639:trends; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000209:etiology / Q000517:prevention & control; D002986:Clinical Trials as Topic; D006324:Heart Arrest, Induced / Q000009:adverse effects; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects / Q000379:methods; D007223:Infant; D007430:Intraoperative Care / Q000379:methods; D018696:Neuroprotective Agents / Q000627:therapeutic use; D012308:Risk Management / Q000379:methods*; D014462:Ultrafiltration / Q000379:methods
D018696:Neuroprotective Agents