TY - JOUR
T1 - Beyond Anesthesia Toxicity
T2 - Anesthetic Considerations to Lessen the Risk of Neonatal Neurological Injury
AU - McCann, Mary Ellen
AU - Lee, Jennifer K.
AU - Inder, Terrie
N1 - Funding Information:
Name: Mary Ellen McCann, MD. Contribution: This author helped write, edit, and revise the manuscript. Conflicts of Interest: None. Name: Jennifer K. Lee, MD. Contribution: This author helped write, edit, and revise the manuscript. Conflicts of Interest: J. K. Lee received prior research funding from Covidien and Medtronic, and she previously consulted for Medtronic. Name: Terrie Inder, MBChB. Contribution: This author helped write, edit, and revise the manuscript. Conflicts of Interest: None. This manuscript was handled by: James A. DiNardo, MD, FAAP.
Funding Information:
Funding: This work was supported by funding from the National Institutes of Health grants (grant no. 1R01HD081303-01, 1-R01 HD06 1136-01A1), Food and Drug Administration grant (grant FDA-SOL-08-SAFEKIDS-Clin 002-Project 2) and the Thrasher Foundation for M.E.M.
Publisher Copyright:
© 2019 International Anesthesia Research Society.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Infants who undergo surgical procedures in the first few months of life are at a higher risk of death or subsequent neurodevelopmental abnormalities. Although the pathogenesis of these outcomes is multifactorial, an understanding of the nature and pathogenesis of brain injury in these infants may assist the anesthesiologist in consideration of their day-to-day practice to minimize such risks. This review will summarize the main types of brain injury in preterm and term infants and their key pathways. In addition, the review will address key potential pathogenic pathways that may be modifiable including intraoperative hypotension, hypocapnia, hyperoxia or hypoxia, hypoglycemia, and hyperthermia. Each of these conditions may increase the risk of perioperative neurological injury, but their long-term ramifications are unclear.
AB - Infants who undergo surgical procedures in the first few months of life are at a higher risk of death or subsequent neurodevelopmental abnormalities. Although the pathogenesis of these outcomes is multifactorial, an understanding of the nature and pathogenesis of brain injury in these infants may assist the anesthesiologist in consideration of their day-to-day practice to minimize such risks. This review will summarize the main types of brain injury in preterm and term infants and their key pathways. In addition, the review will address key potential pathogenic pathways that may be modifiable including intraoperative hypotension, hypocapnia, hyperoxia or hypoxia, hypoglycemia, and hyperthermia. Each of these conditions may increase the risk of perioperative neurological injury, but their long-term ramifications are unclear.
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U2 - 10.1213/ANE.0000000000004271
DO - 10.1213/ANE.0000000000004271
M3 - Review article
C2 - 31517675
AN - SCOPUS:85073303558
VL - 129
SP - 1354
EP - 1364
JO - Anesthesia and Analgesia
JF - Anesthesia and Analgesia
SN - 0003-2999
IS - 5
ER -