Neurodevelopment in the Congenital Heart Disease Population as Framed by the Life Course Health Development Framework
Neurodevelopment in the Congenital Heart Disease Population as Framed by the Life Course Health Development Framework
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DOI：
10.1097/jcn.0000000000000977
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发表时间：
2024-03-01
影响因子：
2
通讯作者：
Harrison, Tondi M.
中科院分区：
文献类型：
--
作者：
Smith, Lindsay M.;Harrison, Tondi M.
背景神经发育不良是先天性心脏病（CHD）的常见合并症。神经发育不良的后果贯穿整个生命过程。神经发育不良的原因是多方面的，本文的目的是（1）将生命过程健康发展框架应用于CHD人群的神经发育，（2）讨论儿童心脏重症监护室（PCICU）的暴露如何影响CHD患者的神经发育。在婴儿期的环境是一个点的干预，以改善神经发育outcomes.ConclusionIndividuals与CHD是在整个生命过程中不利的神经发育的风险增加。PCICU环境是改善神经发育结局的干预点。压力会导致大脑结构和功能的变化，这些变化与外在行为和功能能力方面的负面结果有关，PCICU环境是压力刺激的来源。婴儿期是一个时期的大脑快速增长，大脑是更容易受到压力，在这一时期的生命历程，把婴儿接受护理的PCICU在不利的neurodevelopment.Clinical的风险增加的ImplicationsInterventions，以支持最佳的神经发育应集中在PCICU环境在婴儿期。应探讨发展支持护理模式作为改善PCICU环境的一种手段。此外，PCICU与神经发育之间的关系需要更多的研究。所介绍的概念模型可以作为本研究的起点。
BackgroundAdverse neurodevelopment is a common comorbidity associated with congenital heart disease (CHD). The consequences of adverse neurodevelopment are seen across the life course. The cause of adverse neurodevelopment is multifactorial, and use of a life course perspective can assist with understanding and enhancing neurodevelopment in individuals with CHD.PurposeThe purposes of this article are to (1) apply the Life Course Health Development framework to neurodevelopment in the population with CHD and (2) discuss how exposure to the pediatric cardiac intensive care unit (PCICU) environment during infancy is a point of intervention for improving neurodevelopmental outcomes.ConclusionIndividuals with CHD are at an increased risk for adverse neurodevelopment across the life course. The PCICU environment is a point of intervention for improving neurodevelopmental outcomes. Stress can lead to changes in brain structure and function that are associated with negative outcomes in terms of outward behavioral and functional capacity, and the PCICU environment is a source of stressful stimuli. Infancy is a period of rapid brain growth, and the brain is more susceptible to stress during this period of the life course, putting infants receiving care in the PCICU at an increased risk of adverse neurodevelopment.Clinical ImplicationsInterventions to support optimal neurodevelopment should focus on the PCICU environment during infancy. Developmentally supportive care models should be explored as a means of modifying the PCICU environment. In addition, more research is needed on the relationship between the PCICU and neurodevelopment. The conceptual model introduced can serve as a starting point for this research.