Circulation. 2012 Aug 28;126(9):1143-72. doi: 10.1161/CIR.0b013e318265ee8a. Epub 2012 Jul 30.
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.
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.
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.
本声明的目的是回顾现有的关于监测、筛查、评估和管理策略的文献，并提出一项科学声明，全面审查文献并提出建议，以优化儿科先天性心脏病（CHD）患者的神经发育结局。
由美国心脏协会和美国儿科学会任命的一个写作小组审查了现有的关于 CHD 人群中发育障碍和残疾以及发育迟缓的文献，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 数据库进行了英文文章的搜索，交叉引用了 CHD 和相关搜索词。还搜索了确定文章的参考文献列表。使用了美国心脏病学会/美国心脏协会实践指南推荐分类和证据级别。设计了一种管理算法，根据既定的危险因素对 CHD 儿童进行分层。对于那些被认为有发育障碍或残疾或发育迟缓高风险的儿童，建议进行正式的定期发育和医疗评估。已经构建了用于监测、筛查、评估、重新评估和管理发育障碍或残疾的 CHD 算法，作为 2006 年美国儿科学会关于发育监测和筛查的声明的补充。所提出的算法旨在在医疗之家的背景下实施。本科学声明旨在为医疗之家内照顾 CHD 患者的医疗服务提供者提供服务。
CHD 患儿有发生发育障碍或残疾或发育迟缓的风险增加。在整个儿童期进行定期的发育监测、筛查、评估和重新评估可能会增强对显著缺陷的识别，从而能够进行适当的治疗和教育，以提高后期的学业、行为、心理社会和适应性功能。
