Complicaciones neurológicas en el postoperatorio inmediato de cirugía cardiacatodavía un largo camino por recorrer
- Alejandro Ávila-Álvarez
- I. González-Rivera
- A. Ferrer-Barba
- Francisco Portela
- E. González-Garcia
- José Luis Fernández Trisac
- C. Ramil Fraga
ISSN: 1695-4033, 1696-4608
Ano de publicación: 2012
Volume: 76
Número: 4
Páxinas: 192-198
Tipo: Artigo
Outras publicacións en: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría ( AEP )
Resumo
Introduction There has been an increasing concern over the neurological complications associated with congenital heart disease and cardiac surgery. Material and 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.