Effect of infant anesthesia on IQ scores

Editor's Note

In children undergoing staged reconstructive surgery for hypoplastic left heart syndrome, increasing cumulative exposure to volatile anesthetic agents beginning in infancy was associated with worse performance on IQ scores between ages 4 and 5, this study finds.

This is the first study to link neurodevelopment outcomes with cardiac surgery in infants, suggesting that anesthesia exposure may be a modifiable risk factor, the authors say.

A total of 96 patients were included in this study from Children’s Hospital of Philadelphia.

Despite improved survival in children with hypoplastic left heart syndrome (HLHS), significant concern persists regarding their neurodevelopmental (ND) outcomes. Previous studies have identified patient factors, such as prematurity and genetic syndromes, to be associated with worse ND outcomes. However, no consistent relationships have been identified among modifiable management factors, including cardiopulmonary bypass strategies, and ND outcomes after cardiac surgery in infancy. Studies in immature animals, including primates, have demonstrated neurodegeneration and apoptosis in the brain after certain levels and extended durations of anesthetic exposure.