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Impact of postoperative necrotizing enterocolitis after neonatal cardiac surgery on neurodevelopmental outcome at 1 year of age.
Knirsch, Walter; De Silvestro, Alexandra; Rathke, Verena; L'Ebraly, Christelle; Natterer, Julia C; Schneider, Juliane; Sekarski, Nicole; Latal, Beatrice; Borradori-Tolsa, Cristina; Bouhabib, Maya S; Fuhrer Kradolfer, Katharina; Glöckler, Martin; Hutter, Damian; Pfluger, Marc R; Kaiser, Lena; Polito, Angelo; Kelly-Geyer, Janet F; von Rhein, Michael.
Afiliación
  • Knirsch W; Pediatric Cardiology, Pediatric Heart Center, Children's Research Center, University Children's Hospital, University of Zurich, Zurich, Switzerland.
  • De Silvestro A; Pediatric Cardiology, Pediatric Heart Center, Children's Research Center, University Children's Hospital, University of Zurich, Zurich, Switzerland.
  • Rathke V; Pediatric Cardiology, Pediatric Heart Center, Children's Research Center, University Children's Hospital, University of Zurich, Zurich, Switzerland.
  • L'Ebraly C; Pediatric Cardiology, Woman-Mother-Child Department, University Hospital Lausanne, Lausanne, Switzerland.
  • Natterer JC; Pediatric Cardiology, Woman-Child-Adolescent Department, University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
  • Schneider J; Pediatric Intensive Care Unit, Woman-Mother-Child Department, University Hospital Lausanne, Lausanne, Switzerland.
  • Sekarski N; Neonatology, Woman-Mother-Child Department, University Hospital Lausanne, Lausanne, Switzerland.
  • Latal B; Pediatric Cardiology, Woman-Mother-Child Department, University Hospital Lausanne, Lausanne, Switzerland.
  • Borradori-Tolsa C; Child Development Center, Children's Research Center, University Children's Hospital, University of Zurich, Zurich, Switzerland.
  • Bouhabib MS; Development and Growth, Department of Pediatrics, University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
  • Fuhrer Kradolfer K; Pediatric Cardiology, Woman-Child-Adolescent Department, University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
  • Glöckler M; Pediatric Neurology, Bern, Switzerland.
  • Hutter D; Pediatric Cardiology, Center for Congenital Heart Disease, Department of Cardiology and Cardiac Surgery, University Children's Hospital, University of Bern, Bern, Switzerland.
  • Pfluger MR; Pediatric Cardiology, Center for Congenital Heart Disease, Department of Cardiology and Cardiac Surgery, University Children's Hospital, University of Bern, Bern, Switzerland.
  • Kaiser L; Pediatric Cardiology, Center for Congenital Heart Disease, Department of Cardiology and Cardiac Surgery, University Children's Hospital, University of Bern, Bern, Switzerland.
  • Polito A; Pediatric Cardiology, Center for Congenital Heart Disease, Department of Cardiology and Cardiac Surgery, University Children's Hospital, University of Bern, Bern, Switzerland.
  • Kelly-Geyer JF; Pediatric and Neonatal Intensive Care Unit, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
  • von Rhein M; Department of Neonatology and Pediatric Intensive Care, Children's Research Center, University Children's Hospital, University of Zurich, Zurich, Switzerland.
Front Pediatr ; 12: 1380582, 2024.
Article en En | MEDLINE | ID: mdl-39165487
ABSTRACT

Objectives:

We analyzed the impact of postoperative necrotizing enterocolitis (NEC) after cardiac surgery in neonatal age on neurodevelopmental (ND) outcome at 1 year of age.

Methods:

Using data from the Swiss Neurodevelopmental Outcome Registry for Children with Congenital Heart Disease (ORCHID), we analyzed perioperative variables including postoperative NEC (Bell's stage ≥2) and 1-year ND outcome (Bayley III).

Results:

The included patients (n = 101) had congenital heart disease (CHD), categorized as follows 77 underwent biventricular repair for CHD with two functional chambers, 22 underwent staged palliation until the Fontan procedure for CHD with single ventricle physiology (n = 22), or 4 underwent single ventricle palliation or biventricular repair for borderline CHD (n = 4). Neonatal cardiopulmonary bypass (CBP) surgery was performed at a median age (IQR) of 8 (6) days. NEC occurred in 16 patients. Intensive care unit (ICU) length of stay (LOS) and the total duration of the hospitalization were longer in children with NEC than those in others (14 with vs. 8 days without NEC, p < 0.05; 49 with vs. 32 days without NEC, p < 0.05). The Bayley III scores of the analyzed patients determined at an age of 11.5 ± 1.5 months showed cognitive (CCS) (102.2 ± 15.0) and language scores (LCS) (93.8 ± 13.1) in the normal range and motor composite scores (MCS) (88.7 ± 15.9) in the low-normal range. After adjusting for socioeconomic status and CHD type, patients with NEC had lower CCS scores [ß = -11.2 (SE 5.6), p = 0.049]. Using a cumulative risk score including NEC, we found a higher risk score to be associated with both lower CCS [ß = -2.8 (SE 1.3), p = 0.030] and lower MCS [ß = -3.20 (SE 1.3), p = 0.016].

Conclusions:

Postoperative NEC is associated with longer ICU and hospital LOS and contributes together with other complications to impaired ND outcome at 1 year of age. In the future, national and international patient registries may provide the opportunity to analyze large cohorts and better identify the impact of modifiable perioperative risk factors on ND outcome. Clinical Trial Registration ClinicalTrials.gov identifier NCT05996211.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Front Pediatr Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Front Pediatr Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Suiza