title: [Perioperative anesthetic exposure and the neurodevelopmental status of 1 year old baby underwent neonatal cardiac surgery].
abstract: OBJECTIVE
  To determine the association between perioperative anesthetic exposure and neurodevelopmental status at age 1 year old baby underwent complex cardiac surgery.
  
  
  METHODS
  One hundred and fifteen infants were selected from Sichuan People's Hospital. A cohort study was conducted on neonates who underwent complex cardiac surgery. The babies were performed brain MRI before the operation and 7 days after the operation, and 12-month neurodevelopmental testing was carried out with Bayley Scales of Infant and Toddler Development (the third Edition, Bayley-III). Doses of volatile anesthetics (VAA), benzodiazepines, and opioids were determined during the 12 months. The association between peri-operative anesthetic exposure and 12-month neurodevelopmental status were analyzed.
  
  
  RESULTS
  A total of 92 infants were enrolled for the final analysis. Their Bayley-III scores of cognitive, language, and movement were as follows: 104.2 ± 14.7, 85.6 ± 11.3, and 86.9 ± 13.5, respectively. MRI results showed that 17 infants showed pre-operative brain injury and 25 infants showed new post-operative injury. After performing the analysis of stepwise multivariable linear regression, MRI showed the factors affecting neurodevelopment of newborn include the new post-operative injury, higher VAA exposure, fentanyl dose, benzodiazepine dose, ICU length of stay, pre-operative mean regional cerebral oxygen saturation (rSO₂), and abnormal chromosomes.
  
  
  CONCLUSIONS
  VAA exposure and ICU length of stay are associated with poor neurodevelopmental scores at 12 months of age. Further studies need to identify the potential modifiable factors in the peri-operative care of neonates to improve neurodevelopmental outcomes.
authors.affiliation: Department of Anesthesiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China.
authors.forename: Xuejun
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China.
authors.forename: Yongling
authors.initials: Y
authors.lastname: Wan
authors.affiliation: Department of Anesthesiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China.
authors.forename: Kailan
authors.initials: K
authors.lastname: Wen
authors.affiliation: Department of Anesthesiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Liang
authors.affiliation: Department of Anesthesiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Lin
authors.affiliation: Department of Anesthesiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Li
mesh_terms: D000777:Anesthetics / Q000009:adverse effects*; D001569:Benzodiazepines / Q000009:adverse effects; D006348:Cardiac Surgical Procedures; D002657:Child Development / Q000187:drug effects*; D015331:Cohort Studies; D005283:Fentanyl / Q000009:adverse effects; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D059906:Neuroimaging
chemical_list: D000777:Anesthetics; D001569:Benzodiazepines; D005283:Fentanyl