Observational studyEuropean journal of anaesthesiology2022
Neurocardiovascular coupling in congenital diaphragmatic hernia patients undergoing different types of surgical treatment.
Observational study in European journal of anaesthesiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.
- Changes in the Term Neonatal Electroencephalogram with General Anesthesia: A Systematic Review with Narrative Synthesis.Anesthesiology · 2024Pooled it
- Perioperative monitoring in oesophageal atresia and congenital diaphragmatic hernia patients - exploring the impact of diagnosis on neurocardiovascular coupling.Journal of clinical monitoring and computing · 2026Article
- Review
- The heart in congenital diaphragmatic hernia: Knowns, unknowns, and future priorities.Frontiers in pediatrics · 2022Review
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe effect of peri-operative management on the neonatal brain is largely unknown. Triggers for perioperative brain injury might be revealed by studying changes in neonatal physiology peri-operatively.
objectiveTo study neonatal pathophysiology and cerebral blood flow regulation peri-operatively using the neuro-cardiovascular graph.
designObservational, prospective cohort study on perioperative neuromonitoring. Neonates were included between July 2018 and April 2020.
settingMulticentre study in two high-volume tertiary university hospitals. PATIENTS: Neonates with congenital diaphragmatic hernia were eligible if they received surgical treatment within the first 28 days of life. Exclusion criteria were major cardiac or chromosomal anomalies, or syndromes associated with altered cerebral perfusion or major neurodevelopmental impairment. The neonates were stratified into different groups by type of peri-operative management.
interventionEach patient was monitored using near-infrared spectroscopy and EEG in addition to the routine peri-operative monitoring. Neurocardiovascular graphs were computed off-line.
main outcome measuresThe primary endpoint was the difference in neurocardiovascular graph connectivity in the groups over time.
resultsThirty-six patients were included. The intraoperative graph connectivity decreased in all patients operated upon in the operation room (OR) with sevoflurane-based anaesthesia ( P < 0.001) but remained stable in all patients operated upon in the neonatal intensive care unit (NICU) with midazolam-based anaesthesia. Thoracoscopic surgery in the OR was associated with the largest median connectivity reduction (0.33 to 0.12, P < 0.001) and a loss of baroreflex and neurovascular coupling. During open surgery in the OR, all regulation mechanisms remained intact. Open surgery in the NICU was associated with the highest neurovascular coupling values.
conclusionNeurocardiovascular graphs provided more insight into the effect of the peri-operative management on the pathophysiology of neonates undergoing surgery. The neonate's clinical condition as well as the surgical and the anaesthesiological approach affected the neonatal physiology and CBF regulation mechanisms at different levels.
trial registrationNL6972, URL: https://www.trialre-gister.nl/trial/6972 .
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