Kovacs Adrienne H, Landzberg Michael J, Goodlin Sarah J
Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Canada.
World J Pediatr Congenit Heart Surg. 2013 Jan;4(1):62-9. doi: 10.1177/2150135112464235.
As a result of advances in the diagnosis and treatment of congenital heart disease (CHD), it is now adult care providers, rather than pediatric providers, who are faced with the majority of patient deaths. Effective advance care planning and end-of-life (EOL) care require open communication and collaboration in order to benefit patients, family members, and clinicians. Published guidelines recommend early completion of advance directives and addressing EOL issues in routine care. This article reviews the pattern of shifting CHD mortality, current knowledge regarding advanced care planning and EOL discussions with adults with CHD (ACHD), and guidelines to facilitate and optimize these important discussions.
由于先天性心脏病（CHD）诊断和治疗技术的进步，如今面临大多数患者死亡情况的是成人护理提供者，而非儿科护理提供者。有效的预先护理计划和临终（EOL）护理需要开放的沟通与协作，以便让患者、家庭成员和临床医生都能受益。已发布的指南建议尽早完成预先医疗指示，并在常规护理中解决临终问题。本文回顾了CHD死亡率转移的模式、目前关于与患有CHD的成年人（ACHD）进行预先护理计划和临终讨论的知识，以及促进和优化这些重要讨论的指南。
