Neurodevelopmental Outcomes in Children With Congenital Heart Disease: Evaluation and Management A Scientific Statement From the American Heart Association
Neurodevelopmental Outcomes in Children With Congenital Heart Disease: Evaluation and Management A Scientific Statement From the American Heart Association
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DOI：
10.1161/cir.0b013e318265ee8a
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发表时间：
2012-08-28
期刊：
影响因子：
37.8
通讯作者：
Mahle, William T.
中科院分区：
文献类型：
--
作者：
Marino, Bradley S.;Lipkin, Paul H.;Mahle, William T.
背景 - 本声明的目的是回顾有关监测、筛查、评估和管理策略的现有文献，并提出一份科学声明，全面回顾文献并提出优化儿科先天性心脏病 (CHD) 人群神经发育结果的建议。方法和结果 - 由美国心脏协会和美国儿科学会指定的写作小组回顾了有关 CHD 人群发育障碍、残疾和发育迟缓的现有文献，特别关注监测、筛查、评估和管理策略。对 1966 年至 2011 年的 MEDLINE 和 Google Scholar 数据库进行了交叉引用 CHD 和相关搜索词的英语文章搜索。还检索了已识别文章的参考文献列表。使用美国心脏病学会/美国心脏协会的建议分类和实践指南的证据级别。设计了一种管理算法，根据既定的危险因素对患有先心病的儿童进行分层。对于那些被认为具有发育障碍或残疾或发育迟缓高风险的人，建议进行正式、定期的发育和医学评估。用于发育障碍或残疾的监测、筛查、评估、重新评估和管理的 CHD 算法已经构建，作为 2006 年美国儿科学会关于发育监测和筛查声明的补充。所提出的算法旨在在医疗之家的背景下执行。这一科学声明适用于医疗之家内照顾先心病患者的医疗提供者。结论 - 患有先心病的儿童出现发育障碍、残疾或发育迟缓的风险增加。在整个童年时期定期进行发育监测、筛查、评估和重新评估可以增强对重大缺陷的识别，从而可以进行适当的治疗和教育，以增强以后的学业、行为、心理社会和适应功能。 （流通。2012 年；126：1143-1172。）
Background-The goal of this statement was to review the available literature on surveillance, screening, evaluation, and management strategies and put forward a scientific statement that would comprehensively review the literature and create recommendations to optimize neurodevelopmental outcome in the pediatric congenital heart disease (CHD) population.Methods and Results-A writing group appointed by the American Heart Association and American Academy of Pediatrics reviewed the available literature addressing developmental disorder and disability and developmental delay in the CHD population, with specific attention given to surveillance, screening, evaluation, and management strategies. MEDLINE and Google Scholar database searches from 1966 to 2011 were performed for English-language articles cross-referencing CHD with pertinent search terms. The reference lists of identified articles were also searched. The American College of Cardiology/American Heart Association classification of recommendations and levels of evidence for practice guidelines were used. A management algorithm was devised that stratified children with CHD on the basis of established risk factors. For those deemed to be at high risk for developmental disorder or disabilities or for developmental delay, formal, periodic developmental and medical evaluations are recommended. A CHD algorithm for surveillance, screening, evaluation, reevaluation, and management of developmental disorder or disability has been constructed to serve as a supplement to the 2006 American Academy of Pediatrics statement on developmental surveillance and screening. The proposed algorithm is designed to be carried out within the context of the medical home. This scientific statement is meant for medical providers within the medical home who care for patients with CHD.Conclusions-Children with CHD are at increased risk of developmental disorder or disabilities or developmental delay. Periodic developmental surveillance, screening, evaluation, and reevaluation throughout childhood may enhance identification of significant deficits, allowing for appropriate therapies and education to enhance later academic, behavioral, psychosocial, and adaptive functioning. (Circulation. 2012; 126: 1143-1172.)