Seizure After Cardiopulmonary bypass Surgery: A Retrospective Study

Abstract Background: We are to investigate prognostic factors of seizure after cardiopulmonary bypass surgery based on the incidence, the operation parameters, and the outcomes of seizure.Methods: Consecutive patients presented a seizure after a cardiac or aortic surgery using a cardiopulmonary bypass (CPB) during the admission between January 2006 and January 2019 were retrospectively enrolled. Patients with a previous seizure history were excluded. The medical records were reviewed on the demographics, associated medical conditions, laboratory, electroencephalography (EEG), and imaging findings, cardiopulmonary bypass parameters, types of seizure, and prognosis.Results: Among the 488 patients who received cardiopulmonary surgery using CPB, 29 patients were diagnosed with seizure during admission. There were nine cases of aortic valve replacement, six of mitral valve replacement, four of aorta graft, two of patent ductus arteriosus closure, coronary artery bypass graft, tricuspid annuloplasty, and tumor resection for each. The average durations of the operation and of cardiopulmonary bypass were 278±119 and 108±55 minutes, respectively. The average aortic cross clamping time was 72±41 minutes. The median detection time of a seizure was 34.38±83.37 hours after surgery. Twenty-three patients (79.3%) did not show recovery of mental status after surgery until the seizure was detected. Seventeen patients were diagnosed with status epilepticus, and two of them had nonconvulsive status epilepticus. Nine showed repetitive seizures and three presented a single seizure. EEG analysis showed five cases of spike-and-wave, four of periodic discharges, four of rhythmic delta, and one of burst suppression. From the image studies, sixteen patients showed stroke, two revealed posterior reversible encephalopathy syndrome, and two showed seizure related changes. Nine (31.0%) expired in 25±27 postoperative day. For the survived patients, the average duration of ICU admission was 9±7 days.Conclusions: Due to its difficulty of detecting preclinical seizure after the surgery, evaluation including performance of EEG in early postoperative phase should be considered.

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Prevalence of Heparin-Associated Antibodies Without Thrombosis in Patients Undergoing Cardiopulmonary Bypass Surgery

Circulation ◽

10.1161/01.cir.95.5.1242 ◽

1997 ◽

Vol 95 (5) ◽

pp. 1242-1246 ◽

Cited By ~ 241

Author(s):

Thomas L. Bauer ◽

Gowthami Arepally ◽

Barbara A. Konkle ◽

Bernadette Mestichelli ◽

Sandor S. Shapiro ◽

...

Keyword(s):

Cardiopulmonary Bypass ◽

Bypass Surgery ◽

Cardiopulmonary Bypass Surgery

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Pulmonary infection after cardiopulmonary bypass surgery in children: a risk estimation model in China

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01450-w ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Chunnian Ren ◽

Chun Wu ◽

Zhengxia Pan ◽

Quan Wang ◽

Yonggang Li

Keyword(s):

Risk Factors ◽

Cardiopulmonary Bypass ◽

Prediction Model ◽

Congenital Heart ◽

Bypass Surgery ◽

Pulmonary Infection ◽

Regression Analyses ◽

Cardiopulmonary Bypass Surgery ◽

Independent Risk Factors ◽

Individualized Prediction

Abstract Objectives The occurrence of pulmonary infection after congenital heart disease (CHD) surgery can lead to significant increases in intensive care in cardiac intensive care unit (CICU) retention time, medical expenses, and risk of death risk. We hypothesized that patients with a high risk of pulmonary infection could be screened out as early after surgery. Hence, we developed and validated the first risk prediction model to verify our hypothesis. Methods Patients who underwent CHD surgery from October 2012 to December 2017 in the Children’s Hospital of Chongqing Medical University were included in the development group, while patients who underwent CHD surgery from December 2017 to October 2018 were included in the validation group. The independent risk factors associated with pulmonary infection following CHD surgery were screened using univariable and multivariable logistic regression analyses. The corresponding nomogram prediction model was constructed according to the regression coefficients. Model discrimination was evaluated by the area under the receiver operating characteristic curve (ROC) (AUC), and model calibration was conducted with the Hosmer-Lemeshow test. Results The univariate and multivariate logistic regression analyses identified the following six independent risk factors of pulmonary infection after cardiac surgery: age, weight, preoperative hospital stay, risk-adjusted classification for congenital heart surgery (RACHS)-1 score, cardiopulmonary bypass time and intraoperative blood transfusion. We established an individualized prediction model of pulmonary infection following cardiopulmonary bypass surgery for CHD in children. The model displayed accuracy and reliability and was evaluated by discrimination and calibration analyses. The AUCs for the development and validation groups were 0.900 and 0.908, respectively, and the P-values of the calibration tests were 0.999 and 0.452 respectively. Therefore, the predicted probability of the model was consistent with the actual probability. Conclusions Identified the independent risk factors of pulmonary infection after cardiopulmonary bypass surgery. An individualized prediction model was developed to evaluate the pulmonary infection of patients after surgery. For high-risk patients, after surgery, targeted interventions can reduce the risk of pulmonary infection.

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