Patients with complex CHDs are at risk for impaired neurological development. There is too little knowledge about the effects of cardiac catheterisation under conscious sedation on electrocortical activity and cerebral oxygenation. This pilot study describes extended neurological function monitoring during paediatric cardiac catheterisation.

We conducted a prospective single-centre study including 52 patients with a median age and body weight of 3.5 [0–17] years and 15.3 [3.7–69.2] kg. Electrocortical activity and cerebral oxygenation were monitored via amplitude-integrated electroencephalography and near-infrared spectroscopy.

The median duration of extended monitoring was 130 [80–275] minutes. After propofol administration, amplitude-integrated electroencephalography amplitudes increased (p < 0.01) with a concomitant change in background patterns from continuous to high voltage in 45 patients (86.5%), while near-infrared spectroscopy decreased in tissue oxygenation index [p < 0.01] as did ΔHb. Propofol in one patient caused a rapidly reversible transition from high voltage to flat tracing and burst-suppression pattern. Cardiac interventions and arrhythmias caused short-term variations in near-infrared spectroscopy but had no significant impact on electrocortical activity.

Paediatric cardiac catheterisation under conscious sedation is associated with a high degree of patient safety. Extended monitoring of neurological function may be crucial to minimise risks and adjust conscious sedation levels, especially in high-risk patients.

Literature is lacking to guide standardised care and assessment practices for paediatric patients post cardiac catheterisation. In response to this gap, we sought to describe the current state of practice in cardiology programmes performing paediatric cardiac catheterisations procedures in the United States of America.

A web-based survey was distributed to the Congenital Cardiovascular Interventional Study Consortium Listserv, with representation from 113 identified institutions. A 36-question survey, including fixed-choice and open-ended questions, was developed and piloted for reliability and validity before distribution. Data were summarised descriptively with count and frequency or median and range.

Of the 113 identified institutions, 52% (n=59) responded to the survey. Manual pressure is used to achieve haemostasis by 94.9% of the respondents. Pressure dressings are used by a majority of the facilities and the length of time for bed rest is variable, with the majority using 6 hours for arterial access and 4 hours for venous access. Predominantly, respondents use the time of haemostasis as the start time of bed rest while a third of respondents reported using the time the sheath was removed.

In this study, variation in a number of post catheterisation care and assessment practices for paediatric patients was noted across cardiology programmes. Information from this assessment identifies key opportunities to collaborate in developing standardised practices for the care and assessment of the paediatric patients post catheterisation.