Congenital heart diseaseCohort study
Temperature and Neurologic Outcomes in Neonates Undergoing Cardiac Surgery
- Retrospective cohort study
- registry-based
- mixed-effect logistic regression
Authors' conclusion
Whereas neurological injuries are prevalent after neonatal cardiac surgery, current practices lean towards higher core temperatures. This trend is supported by the nonsignificant impact of NIT on neurological outcomes.
Study context
- Population
- Neonates undergoing congenital heart surgery, STS Congenital Heart Surgery Database, 2010–2019
- Participants
- 24,345 neonatal cardiac operations
- Exposure
- Nadir intraoperative temperature and early neurological outcomes
- Outcome
- Major neurological injury (stroke, seizure, or deficit at discharge)
Main finding
As reported in the abstract
Major neurological injury
Major neurological injury in the cohort
4.9%
Observational data: associations, not effects.
Further findings
Major neurological injury, Norwood subgroup
- Lower nadir intraoperative temperature (NIT) showed protective effects in the Norwood subgroup
Mean nadir temperature over time
- Shift from hypothermic circulatory arrest to cerebral perfusion; mean nadir temperature increased from 23.9 °C to 25.6 °C
- P < 0.0001
Risk factors for major neurological injury
- Younger age at surgery, Norwood procedure, longer CPB times, younger gestational age, noncardiac abnormalities and chromosomal anomalies increased risk
Original publication
Temperature and Neurologic Outcomes in Neonates Undergoing Cardiac Surgery. J Am Coll Cardiol. Published 30 July 2024. doi:10.1016/j.jacc.2024.04.059
Summarised from the published abstract; every number is checked against it