Doherty Catherine, Holtby Helen
Department of Anaesthesia and Pain Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada.
Paediatr Anaesth. 2011 May;21(5):609-14. doi: 10.1111/j.1460-9592.2010.03492.x. Epub 2010 Dec 28.
More children die of congenital heart disease (CHD) in low-income countries and acquired cardiac disease is more frequent. Advances in diagnosis, surgery, perfusion and anesthesia in the developed world have had dramatic results on children's lives, and many forms of CHD can now be safely corrected or palliated. However, in developing countries, for the children who receive cardiac surgery, perioperative mortality and morbidity remain high. Pediatric cardiac anesthesia is a specialty in its infancy worldwide, and in developing countries, it is often nonexistent. Visiting 'specialists' as part of medical mission teams often provides anesthesia, but the hope for the future is that local staff will be trained in pediatric cardiac anesthesia and collaborative regional cardiac centers will be the mainstay of care, offering safer surgery to more children.
在低收入国家,死于先天性心脏病(CHD)的儿童更多,且后天性心脏病更为常见。发达国家在诊断、手术、灌注和麻醉方面的进展对儿童的生命产生了显著影响,现在许多形式的先天性心脏病都可以得到安全矫正或缓解。然而,在发展中国家,接受心脏手术的儿童围手术期死亡率和发病率仍然很高。儿科心脏麻醉在全球范围内尚处于起步阶段,在发展中国家,这一领域往往不存在。作为医疗援助团队一部分前来的“专家”常常提供麻醉服务,但未来的希望是当地工作人员能够接受儿科心脏麻醉培训,协作性区域心脏中心将成为主要的医疗支柱,为更多儿童提供更安全的手术。