Critical Care Clinical Nurse Specialist Role in Developmental Care for Infants With Heart Disease

摘要

Infants born with congenital heart disease (CHD) experience dramatically improved survival as a result of advances in CHD recognition, surgical techniques, and perioperative management; it is now expected that up to 85% of children with CHD will survive to adulthood.1 Improved survival has led to the recognition of developmental delays in many infants and children with CHD. There is a spectrum of these delays, including cognitive, fine and gross motor skills, executive functioning, language and visual processing, attention, and psychosocial development delays.1 These delays are more prevalent and severe in those with more complex CHD, related in part to an increased incidence of comorbid conditions and need for complex intervention during the developmentally sensitive neonatal period.1 The American Heart Association developed guidelines for ongoing neurodevelopmental screening and referral for all infants and children with CHD; these guidelines were endorsed by the American Academy of Pediatrics, but consistent implementation of these guidelines has been problematic.