Perioperative risk factors were inconsistently associated with developmental outcomes .
INTERPRETATION The literature on children undergoing surgery in early infancy suggests that infants with a single ventricle are at highest risk of adverse developmental outcomes .
WHAT THIS PAPER ADDS Children with complex congenital heart disease ( CHD ) are at increased risk of impaired developmental outcome .
Children with single-ventricle CHD have worse outcomes than children with two-ventricle CHD .
Children with two-ventricle CHD gradually grow out of their initial developmental impairment .
Perioperative factors are inconsistently associated with outcome
AIM ( 1 ) To systematic ally review the literature on developmental outcomes from infancy to adolescence of children with complex congenital heart disease ( CHD ) who underwent early surgery ; ( 2 ) to run a meta-regression analysis on the Bayley Scales of Infant Development , Second Edition Mental Developmental Index and Psychomotor Developmental Index ( PDI ) of infants up to 24 months and IQs of preschool-aged children to adolescents ; ( 3 ) to assess associations between perioperative risk factors and outcomes .
Neurotoxicity of sedative and analgesia drugs in young infants with congenital heart disease: 4-year follow-up.
OBJECTIVES / AIM To determine whether sedation/analgesia drugs used before , during , and after infant cardiac surgery are associated with neurocognitive and functional outcomes . BACKGROUND Some animal models suggest neurotoxic effects of anesthetic drugs on the developing brain ; however , potential human effects are unknown . Whether these results can be extrapolated to humans is unknown . METHODS / MATERIAL S Prospect i ve follow-up project of all infants ≤6 weeks old having surgery for congenital heart disease between 04/03 and 12/06 . Demographic , perioperative , and sedation/analgesia variables were collected . Outcomes at kindergarten age were Wechsler Preschool and Primary Scale of Intelligence-III , Beery-Buktenica Developmental Test of Visual Motor Integration ( VMI-V ) , and General Adaptive Composite ( GAC ) of the Adaptive Behavior Assessment System-II .  Multivariable linear regression was used to identify predictor variables . RESULTS From 135 infants who underwent heart surgery , 19 died , 17 were excluded , 8 were lost to follow-up , leaving 91 children for analysis . Multiple linear regression found days on chloral hydrate [ 3.5 ( 3.7 ) days ] was associated with lower performance intelligence quotient ( PIQ ) ( Effect size -1.03 ; 95 % CI -1.96 , -0.10 ; P = 0.03 ) , and cumulative dose [ 54.2 ( 60.3 ) mg·kg(-1 ) ] of benzodiazepines was associated with lower VMI scores ( Effect size -0.07 ; 95 % CI -0.12 , -0.01 ; P = 0.026 ) . No other associations were found between sedation/analgesia variables and full-scale IQ , PIQ , Verbal IQ , VMI , or GAC . CONCLUSION Assessment of this cohort at kindergarten age found a small statistically significant association between days on chloral hydrate and PIQ , and benzodiazepine cumulative dose and lower VMI . No other association between sedation/analgesia drugs and outcomes was found
Perioperative risk factors were inconsistently associated with developmental outcomes .
INTERPRETATION The literature on children undergoing surgery in early infancy suggests that infants with a single ventricle are at highest risk of adverse developmental outcomes .
WHAT THIS PAPER ADDS Children with complex congenital heart disease ( CHD ) are at increased risk of impaired developmental outcome .
Children with single-ventricle CHD have worse outcomes than children with two-ventricle CHD .
Children with two-ventricle CHD gradually grow out of their initial developmental impairment .
Perioperative factors are inconsistently associated with outcome
AIM ( 1 ) To systematic ally review the literature on developmental outcomes from infancy to adolescence of children with complex congenital heart disease ( CHD ) who underwent early surgery ; ( 2 ) to run a meta-regression analysis on the Bayley Scales of Infant Development , Second Edition Mental Developmental Index and Psychomotor Developmental Index ( PDI ) of infants up to 24 months and IQs of preschool-aged children to adolescents ; ( 3 ) to assess associations between perioperative risk factors and outcomes .