TY - JOUR
T1 - Neuromonitoring, neuroimaging, and neurodevelopmental follow-up practices in neonatal congenital heart disease
T2 - a European survey
AU - Feldmann, Maria
AU - Hagmann, Cornelia
AU - de Vries, Linda
AU - Disselhoff, Vera
AU - Pushparajah, Kuberan
AU - Logeswaran, Thushiha
AU - Jansen, Nicolaas J.G.
AU - Breur, Johannes M.P.J.
AU - Knirsch, Walter
AU - Benders, Manon
AU - Counsell, Serena
AU - Reich, Bettina
AU - Latal, Beatrice
N1 - Funding Information:
We would like to thank all members of the European Association Brain in Congenital Heart Disease (European ABC) for their contribution to this work: R. Stegeman, N.H.P. Claessens, M. Nijman, F. Haas, R. Kottke, J. Simpson, A.F. Bonthrone, C.J. Kelly, S. Arulkumaran, M.A. Rutherford, D. Cromb, M. Haak, C. Steger, A. De Silvestro, C. Austin, F. Groenendaal, J. Nijman.
Funding Information:
The European Association Brain and Congenital Heart Disease (ABC) Consortium is a multicenter, multidisciplinary group, financially supported by the European Society for Paediatric Research, that aims to promote research in the field of brain development in CHD children and, thereby, improve the neurodevelopmental outcome of infants with severe CHD. With this survey, we aimed to obtain detailed information on neuromonitoring practices in European centers caring for neonates with CHD. We designed and distributed an online survey inquiring about the use and timing of neuromonitoring and neuroimaging tools in pediatric cardiac surgical centers. Furthermore, we obtained information on the implementation of neurodevelopmental follow-up programs and the general interest in a European neurodevelopmental outcome registry. The results of this survey may serve as the basis for the development of an expert panel recommendation on neuromonitoring, neuroimaging, and neurodevelopmental follow-up in CHD patients undergoing neonatal cardiac surgery.
Funding Information:
This research was funded by a Consolidator Grant of the European Society of Paediatric Research (ESPR). Open access funding provided by University of Zurich.
Publisher Copyright:
© 2022, The Author(s).
PY - 2023/1
Y1 - 2023/1
N2 - Background: Brain injury and neurodevelopmental impairment remain a concern in children with complex congenital heart disease (CHD). A practice guideline on neuromonitoring, neuroimaging, and neurodevelopmental follow-up in CHD patients undergoing cardiopulmonary bypass surgery is lacking. The aim of this survey was to systematically evaluate the current practice in centers across Europe. Methods: An online-based structured survey was sent to pediatric cardiac surgical centers across Europe between April 2019 and June 2020. Results were summarized by descriptive statistics. Results: Valid responses were received by 25 European centers, of which 23 completed the questionnaire to the last page. Near-infrared spectroscopy was the most commonly used neuromonitoring modality used in 64, 80, and 72% preoperatively, intraoperatively, and postoperatively, respectively. Neuroimaging was most commonly performed by means of cranial ultrasound in 96 and 84% preoperatively and postoperatively, respectively. Magnetic resonance imaging was obtained in 72 and 44% preoperatively and postoperatively, respectively, but was predominantly reserved for clinically symptomatic patients (preoperatively 67%, postoperatively 64%). Neurodevelopmental follow-up was implemented in 40% of centers and planned in 24%. Conclusions: Heterogeneity in perioperative neuromonitoring and neuroimaging practice in CHD in centers across Europe is large. The need for neurodevelopmental follow-up has been recognized. A clear practice guideline is urgently needed. Impact: There is large heterogeneity in neuromonitoring, neuroimaging, and neurodevelopmental follow-up practices among European centers caring for neonates with complex congenital heart disease.This study provides a systematic evaluation of the current neuromonitoring, neuroimaging, and neurodevelopmental follow-up practice in Europe.The results of this survey may serve as the basis for developing a clear practice guideline that could help to early detect and prevent neurological and neurodevelopmental sequelae in neonates with complex congenital heart disease.
AB - Background: Brain injury and neurodevelopmental impairment remain a concern in children with complex congenital heart disease (CHD). A practice guideline on neuromonitoring, neuroimaging, and neurodevelopmental follow-up in CHD patients undergoing cardiopulmonary bypass surgery is lacking. The aim of this survey was to systematically evaluate the current practice in centers across Europe. Methods: An online-based structured survey was sent to pediatric cardiac surgical centers across Europe between April 2019 and June 2020. Results were summarized by descriptive statistics. Results: Valid responses were received by 25 European centers, of which 23 completed the questionnaire to the last page. Near-infrared spectroscopy was the most commonly used neuromonitoring modality used in 64, 80, and 72% preoperatively, intraoperatively, and postoperatively, respectively. Neuroimaging was most commonly performed by means of cranial ultrasound in 96 and 84% preoperatively and postoperatively, respectively. Magnetic resonance imaging was obtained in 72 and 44% preoperatively and postoperatively, respectively, but was predominantly reserved for clinically symptomatic patients (preoperatively 67%, postoperatively 64%). Neurodevelopmental follow-up was implemented in 40% of centers and planned in 24%. Conclusions: Heterogeneity in perioperative neuromonitoring and neuroimaging practice in CHD in centers across Europe is large. The need for neurodevelopmental follow-up has been recognized. A clear practice guideline is urgently needed. Impact: There is large heterogeneity in neuromonitoring, neuroimaging, and neurodevelopmental follow-up practices among European centers caring for neonates with complex congenital heart disease.This study provides a systematic evaluation of the current neuromonitoring, neuroimaging, and neurodevelopmental follow-up practice in Europe.The results of this survey may serve as the basis for developing a clear practice guideline that could help to early detect and prevent neurological and neurodevelopmental sequelae in neonates with complex congenital heart disease.
UR - https://www.scopus.com/pages/publications/85127940665
U2 - 10.1038/s41390-022-02063-2
DO - 10.1038/s41390-022-02063-2
M3 - Article
C2 - 35414671
SN - 0031-3998
VL - 93
SP - 168
EP - 175
JO - Pediatric Research
JF - Pediatric Research
IS - 1
ER -