Backer Carl L, Overman David M, Dearani Joseph A, Romano Jennifer C, Tweddell James S, Kumar S Ram, Marino Bradley S, Bacha Emile A, Jaquiss Robert D B, Zaidi Ali N, Gurvitz Michelle, Costello John M, Pierick Trudy A, Ravekes William J, Reagor James A, St Louis James D, Spaeth James, Mahle William T, Shin Andrew Y, Lopez Keila N, Karamlou Tara, Welke Karl F, Bryant Roosevelt, Husain S Adil, Chen Jonathan M, Kaza Aditya, Wells Winfield J, Glatz Andrew C, Cohen Mitchell I, McElhinney Doff B, Parra David A, Pasquali Sara K
Department of Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Division of Cardiovascular Surgery, Children's Minnesota, Mayo Clinic-Children's Minnesota Cardiovascular Collaborative, Minneapolis, Minn.
J Thorac Cardiovasc Surg. 2023 Dec;166(6):1782-1820. doi: 10.1016/j.jtcvs.2023.09.001. Epub 2023 Sep 29.
Care and outcomes for the more than 40,000 patients undergoing pediatric and congenital heart surgery in the United States annually are known to vary widely. While consensus recommendations have been published across numerous fields as one mechanism to promote a high level of care delivery across centers, it has been more than two decades since the last pediatric heart surgery recommendations were published in the United States. More recent guidance is lacking, and collaborative efforts involving the many disciplines engaged in caring for these children have not been undertaken to date. The present initiative brings together professional societies spanning numerous care domains and congenital cardiac surgeons, pediatric cardiologists, nursing, and other healthcare professionals from diverse programs around the country to develop consensus recommendations for United States centers. The focus of this initial work is on pediatric heart surgery, and it is recommended that future efforts focus in detail on the adult congenital population. We describe the background, rationale, and methodology related to this collaborative effort, and recommendations put forth for Essential Care Centers (essential services necessary for any program), and Comprehensive Care Centers (services to optimize comprehensive and high-complexity care), encompassing structure, process, and outcome metrics across 14 domains.
在美国，每年有超过40000名接受儿科和先天性心脏手术的患者，其护理情况和治疗结果差异很大。虽然在众多领域已发布了共识性建议，作为促进各中心提供高水平护理的一种机制，但美国上一次发布儿科心脏手术建议距今已有二十多年。目前缺乏更新的指导意见，而且迄今为止尚未开展涉及众多参与照料这些儿童的学科的协作努力。本次倡议汇集了涵盖众多护理领域的专业协会以及先天性心脏外科医生、儿科心脏病专家、护士和来自全国各地不同项目的其他医疗保健专业人员，以制定针对美国各中心的共识性建议。这项初步工作的重点是儿科心脏手术，建议未来的工作详细关注成人先天性心脏病患者群体。我们描述了与这项协作努力相关的背景、基本原理和方法，以及针对基本护理中心（任何项目所需的基本服务）和综合护理中心（优化全面和高复杂性护理的服务）提出的建议，涵盖14个领域的结构、过程和结果指标。
