title: [Acute neurological complications after pediatric cardiac surgery: still a long way to go].
abstract: BACKGROUND
  There has been an increasing concern over the neurological complications associated with congenital heart disease and cardiac surgery.
  
  
  METHODS
  We performed a retrospective, case-control, observational review of the postoperative period in the intensive care unit of patients undergoing cardiac surgery over the past 10 years. We selected 2 control patients for each case, matched for surgical complexity.
  
  
  RESULTS
  A total of 900 patients were reviewed. We found 38 neurological complications (4.2%), of which 21 (55.3%) were in the peripheral nervous system and 17 (44.7%) in the central nervous system. The complications involving the central nervous system (1.9% of total) consisted of 8 seizures, 4 cerebrovascular accidents, 4 hypoxic-ischemic encephalopathy events, and 1 reversible neurological deficit. At the time of discharge, 35.3% were symptomatic and 17.6% had died. Patients with neurological complications had a longer bypass time (P=.009), longer aortic cross time (P=.012), longer hospitalization in intensive care (P=.001), longer duration of mechanical ventilation (P=.004) and an increased number of days under inotropic support (P=.001).
  
  
  CONCLUSIONS
  Our incidence of neurological complications after cardiac surgery is similar to that previously described. Clinical seizures are the most common complication. Central nervous system complications are associated with a higher morbidity and hospitalization time. Units caring for patients with congenital heart disease must implement neurological monitoring during and after cardiac surgery to prevent and to detect these complications earlier.
authors: Unidad de Neonatología, Servicio de Pediatría, Complejo Hospitalario Universitario de A Coruña, España. alexavila81@hotmail.com
authors: A
authors: A
authors: Avila-Alvarez
authors: I
authors: I
authors: Gonzalez-Rivera
authors: A
authors: A
authors: Ferrer-Barba
authors: F
authors: F
authors: Portela-Torron
authors: E
authors: E
authors: Gonzalez-Garcia
authors: J L
authors: JL
authors: Fernandez-Trisac
authors: C
authors: C
authors: Ramil-Fraga
mesh_terms: D000208:Acute Disease; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006331:Heart Diseases / Q000150:complications* / Q000151:congenital* / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D009422:Nervous System Diseases / Q000453:epidemiology* / Q000209:etiology*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D012189:Retrospective Studies