Olivieri Laura J, Zurakowski David, Ramakrishnan Karthik, Su Lillian, Alfares Fahad A, Irwin Matthew R, Heichel Jenna, Krieger Axel, Nath Dilip S
1 Division of Cardiology, Children's National Medical Center, Washington, DC, USA.
2 Department of Anesthesia, Boston Children's Hospital, Harvard School of Medicine, Boston, MA, USA.
World J Pediatr Congenit Heart Surg. 2018 Mar;9(2):206-213. doi: 10.1177/2150135117745005.
Postoperative care delivered in the pediatric cardiac intensive care unit (CICU) relies on providers' understanding of patients' congenital heart defects (CHDs) and procedure performed. Novel, bedside use of virtual, three-dimensional (3D) heart models creates access to patients' CHD to improve understanding. This study evaluates the impact of patient-specific virtual 3D heart models on CICU provider attitudes and care delivery.
Virtual 3D heart models were created from standard preoperative cardiac imaging of ten patients with CHD undergoing repair and displayed on a bedside tablet in the CICU. Providers completed a Likert questionnaire evaluating the models' value in understanding anatomy and improving care delivery. Responses were compared using two-tailed t test and Mann-Whitney U test and were also compared to previously collected CICU provider responses regarding use of printed 3D heart models.
Fifty-three clinicians (19 physicians, 34 nurses/trainees) participated; 49 (92%) of 53 and 44 (83%) of 53 reported at least moderate to high satisfaction with the virtual 3D heart's ability to enhance understanding of anatomy and surgical repair, respectively. Seventy-one percent of participants felt strongly that virtual 3D models improved their ability to manage postoperative problems. The majority of both groups (63% physicians, 53% nurses) felt that virtual 3D heart models improved CICU handoffs. Virtual 3D heart models were as effective as printed models in improving understanding and care delivery, with a noted provider preference for printed 3D heart models.
Virtual 3D heart models depicting patient-specific CHDs are perceived to improve understanding and postoperative care delivery in the CICU.
儿科心脏重症监护病房(CICU)提供的术后护理依赖于医护人员对患者先天性心脏病(CHD)及所施行手术的了解。新型的、可在床边使用的虚拟三维(3D)心脏模型能够让医护人员了解患者的先天性心脏病,从而增进理解。本研究评估了针对患者的虚拟3D心脏模型对CICU医护人员态度及护理工作的影响。
根据十名接受修复手术的先天性心脏病患者的标准术前心脏成像创建虚拟3D心脏模型,并在CICU的床边平板电脑上展示。医护人员完成了一份李克特问卷,评估这些模型在理解解剖结构和改善护理工作方面的价值。使用双尾t检验和曼-惠特尼U检验对回答进行比较,并与之前收集的CICU医护人员关于使用打印3D心脏模型的回答进行比较。
53名临床医生(19名医生,34名护士/实习生)参与了研究;53名中的49名(92%)和53名中的44名(83%)分别报告对虚拟3D心脏模型增强解剖结构理解和手术修复理解的能力至少有中度到高度的满意度。71%的参与者强烈认为虚拟3D模型提高了他们处理术后问题的能力。两组中的大多数(63%的医生,53%的护士)认为虚拟3D心脏模型改善了CICU的交接班。虚拟3D心脏模型在增进理解和护理工作方面与打印模型同样有效,不过医护人员明显更倾向于打印3D心脏模型。
描绘特定患者先天性心脏病的虚拟3D心脏模型被认为能增进CICU医护人员的理解并改善术后护理工作。