Adverse events in neonates with congenital heart disease after cardiovascular surgery: a systematic review and meta-analysis

INTRODUCTION: Neonates with congenital heart disease (CHD) undergoing cardiovascular surgery are exposed to complex postoperative care and may experience adverse events. METHODS: A systematic review and meta-analysis was conducted. Searches were performed in the Cochrane Central Register of Controlled Trials, LILACS, CINAHL, EMBASE, PubMed, Web of Science Core Collection, and Scopus. Observational cohort studies evaluating adverse events in neonates were eligible for inclusion. Data extraction was performed independently by two reviewers; in the event of disagreement, a third reviewer was consulted. Search results were exported to the online reference management software EndNote Basic for duplicate removal and subsequently imported into the Rayyan platform. RESULTS: Of the 60 articles identified, 20 studies comprising a total of 25,422 neonates with congenital heart disease in the postoperative period were included. The overall prevalence of adverse events was 14%. The most prevalent events were central venous catheter (CVC)-related incidents (14%), healthcare-associated infections (12%), and extubation failure (11%). CONCLUSIONS: The prevalence of adverse events in neonates with CHD undergoing cardiovascular surgery is substantial and likely underreported. Further studies are needed to improve the detection, mitigation, and reduction of these events.