Table 1.
Multidisciplinary approaches to diagnosis, monitoring, and prevention of neurologic injury throughout the perioperative period
Preoperative | Intraoperative | Postoperative | |
---|---|---|---|
Tools for diagnosis/monitoring | Imaging (ultrasound, MRI) | NIRS | Imaging (ultrasound, MRI) |
EEG, ERP | Biomarkers | NIRS | |
Genetic analysis, risk stratification | Biomarkers | ||
Biomarkers | EEG, ERP | ||
Strategies for neuroprotection | Fetal intervention for CHD (improved cerebral blood flow) | Modified perfusion techniques (RLFP, new circuits, etc.) | Postconditioning therapies |
Prenatal therapy for PVL | Modified cooling/rewarming protocols | Afterload reduction (avoid LCOS) | |
Preconditioning therapies | |||
RIPC | |||
Pharmacologic |
ERP, evoked response potential; NIRS, near-infrared-spectroscopy; CHD, congenital heart disease; LCOS, low cardiac output syndrome; PVL, per ventricular leukomalacia; RIPC, remote ischemic preconditioning.