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Postoperative EEG abnormalities in relation to neurodevelopmental outcomes after pediatric cardiac surgery

  • Clinical Research Article
  • Published:
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Abstract

Background

We had reported that postoperative EEG background including sleep-wake cycle (SWC) and discharge (seizures, spikes/sharp waves) abnormalities were significantly correlated with adverse early outcomes in children after cardiac surgery. We aimed to analyze the relations between these EEG abnormalities and neurodevelopmental outcomes at about 2 years after cardiac surgery.

Methods

We enrolled 121 patients undergoing cardiac surgery at 3.3 months (0.03 ~ 28 months). EEG abnormalities described above during the first postoperative 48 h were evaluated. Griffiths Mental Development Scales-Chinese was used to evaluate the quotients of overall development and 5 subscales of the child’s locomotor, language, personal-social, eye-hand coordination and performance skills at 16 ~ 31 months of age.

Results

EEG background abnormalities occurred in 59/121 (48.8%) patients and 33 (55.9%) unrecovered to normal by 48 h. Abnormal SWC occurred in 15 (12.4%) patients and 7 (5.8%) unrecovered to normal by 48 h. EEG seizures occurred in 11 (9.1%) patients with frontal lobe seizures in 4. Spikes/sharp waves occurred in 100 (82.6%). EEG background abnormalities, number of spikes/sharp waves and frontal lobe seizures were significantly associated with neurodevelopmental impairment at about 1 ~ 2 year after surgery (Ps ≤ 0.05).

Conclusions

Most parameters of EEG abnormalities were significantly associated with neurodevelopmental impairment after cardiac surgery.

Impact

  • Neurodevelopmental impairment in children with congenital heart disease remain poorly understood.

  • Previous studies had reported that either EEG seizures or background abnormalities were associated with worse neurodevelopmental outcomes.

  • Our present study showed that all the EEG background and discharge abnormalities including EEG background, seizures and spikes/sharp waves in the early postoperative period were significantly associated with neurodevelopmental impairment at about 1 ~ 2 years after cardiac surgery.

  • Comprehensive evaluation of early postoperative EEG may provide further insights about postoperative brain injury, its relation with neurodevelopmental impairment, and guide to improve clinical management.

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Fig. 1: Example of EEG category.

Data availability

The data supporting the analyzes are presented in the Open Science Framework at https://osf.io/ynhca/.

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Funding

Funding

Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease and Guangzhou Women and Children’s Medical Center start-up fund to JL. Supported by the Key-Area Research and Development Program of Guangdong Province (No. 2019B020227001); Dr Li’s start-up fund was provided by Guangzhou Women and Children’s Medical Center. The study was reviewed and approved by Guangzhou Women and Children’s Medical Center institutional Research Ethics Boards. (No. 46201; 2019-12-13).

Author information

Author notes

  1. These authors contributed equally: **qing Feng, Rouyi Lin.

  2. These authors jointly supervised this work: Li Ma, Jia Li.

Authors and Affiliations

  1. Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Medical University, Guangzhou, Guangdong Province, China

    **qing Feng, Rouyi Lin, Na Du, Jianbin Li, Yanqin Cui, Guodong Huang, Huaizhen Wang, **nxin Chen, Li Ma & Jia Li

  2. Clinical Physiology Laboratory, Institute of Pediatrics, Guangzhou Medical University, Guangzhou, Guangdong Province, China

    **qing Feng, Rouyi Lin & Jia Li

  3. Department of Neurology, Guangzhou Medical University, Guangzhou, Guangdong Province, China

    Yani Zhang & Wenxiong Chen

  4. Department of Electroneurophysiology, Guangzlhou Medical University, Guangzhou, Guangdong Province, China

    Shuyao Ning

  5. Heart Center, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, Guangdong Province, China

    Na Du, Jianbin Li, Yanqin Cui, Guodong Huang, Huaizhen Wang, **nxin Chen, Techang Liu & Li Ma

Authors
  1. **qing Feng
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Contributions

Designed the study: J.L. Data extraction and acquisition: J.Q.F., R.Y.L., S.Y.N., N.D., J.B.L., Y.Q.C., M.J.Z., G.D.H., H.Z.W., X.X.C, T.C.L, W.X.C., L.M. Drafting the manuscript: J.Q.F., R.Y.L. Contributed to statistical analysis: J.Q.F., R.Y.L., J.L. Interpretation of data: Y.N.Z., S.Y.N., J.B.L., G.D.H., H.Z.W., X.X.C., T.C.L., W.X.C., L.M. Revision of the manuscript: J.L.

Corresponding author

Correspondence to Jia Li.

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After the institutional ethics approval (No. 46201), informed consent was obtained.

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Feng, J., Lin, R., Zhang, Y. et al. Postoperative EEG abnormalities in relation to neurodevelopmental outcomes after pediatric cardiac surgery. Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03401-2

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