Johnson Beth Ann, Shepherd Jennifer, Bhombal Shazia, Ali Noorjahan, Joynt Chloe
Division of Neonatology, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati, OH, USA.
Fetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Semin Perinatol. 2024 Dec;48(8):151989. doi: 10.1016/j.semperi.2024.151989. Epub 2024 Oct 8.
Effective resuscitation of neonates with congenital heart disease (CHD) depends on comprehensive planning, thorough understanding of physiology, vigilant monitoring, and interdisciplinary collaboration to achieve the best outcomes. Neonatal heart disease can affect cardiac structure, rhythm, or ventricular function, and may be either congenital or acquired. Critical congenital heart disease (CCHD) can result in inadequate pulmonary blood flow, impaired intracardiac mixing, airway obstruction, or insufficient cardiac output. Tailored resuscitation strategies are important as early as the delivery room, where some CHD lesions may cause immediate cardiovascular instability during the transition from fetal to postnatal circulation. Premature infants with CHD are at higher risk due to their small size and the complications associated with prematurity, affecting both CHD management and overall clinical stability. Addressing both cardiac and non-cardiac causes of decompensation requires a precise understanding of each patient's unique physiology and trajectory from delivery through postintervention intensive care.
对患有先天性心脏病（CHD）的新生儿进行有效的复苏取决于全面的规划、对生理学的透彻理解、 vigilant监测以及跨学科协作，以实现最佳结果。新生儿心脏病可影响心脏结构、节律或心室功能，可能是先天性的，也可能是后天获得的。严重先天性心脏病（CCHD）可导致肺血流量不足、心内混合受损、气道阻塞或心输出量不足。早在产房就应制定量身定制的复苏策略，因为一些CHD病变在从胎儿循环过渡到产后循环期间可能会立即导致心血管不稳定。患有CHD的早产儿由于体型小以及与早产相关的并发症而面临更高的风险，这会影响CHD的治疗和整体临床稳定性。要解决心脏和非心脏原因导致的失代偿问题，需要精确了解每个患者从分娩到干预后重症监护的独特生理学和病程。
