Caligiuri Laura A, Beslow Lauren, Pardo Andrea C
Division of Neurology, Children's Hospital of Philadelphia, Departments of Neurology and Pediatrics, Perelman School of Medicine at the University of Pennsylvania, 3401 Civic Center Blvd, Philadelphia, PA, 19104, United States.
Division of Neurology, Children's Hospital of Philadelphia, Departments of Neurology and Pediatrics, Perelman School of Medicine at the University of Pennsylvania, 3401 Civic Center Blvd, Philadelphia, PA, 19104, United States.
Semin Fetal Neonatal Med. 2024 Nov;29(2-3):101552. doi: 10.1016/j.siny.2024.101552. Epub 2024 Nov 8.
Pediatric neurocritical care is a field dedicated to providing specialized assessment and care of critically-ill children with neurologic disease or at risk of neurologic compromise. Fellowship programs for providers interested in specializing in pediatric neurocritical care are growing and developing to meet the needs of trainees and the patient populations that they serve. Fetal and neonatal neurocritical care fellowship remains a separate opportunity for training; however, inclusion of fetal and neonatal neurology education into pediatric neurocritical care broadens understanding of normal and pathologic anatomy and physiology, diagnostic interpretation of the developing brain, targeted management interventions, family counseling and prognostication, and long-term optimization of outcomes. For instance, the care of neurologic injury in congenital heart disease emphasizes the incorporation of medical education across the lifespan. Additionally, neonates requiring NICU admission and care are more likely to require future PICU care and be served by neurocritical care providers. Furthermore, neonates with neurologic injury or at risk for neurologic injury are not exclusively admitted to neonatal units. Education across the age-spectrum inclusive of fetal and neonatal neurology is valuable for trainees in understanding underlying disease processes, management, and sequelae and promotes the growth of the field of pediatric neurocritical care.
儿科神经重症监护是一个致力于为患有神经系统疾病或有神经系统功能受损风险的危重症儿童提供专业评估和护理的领域。针对有志于从事儿科神经重症监护专业的医护人员的 fellowship 项目正在不断发展壮大,以满足学员及其所服务患者群体的需求。胎儿和新生儿神经重症监护 fellowship 仍是一个独立的培训机会;然而,将胎儿和新生儿神经学教育纳入儿科神经重症监护,可拓宽对正常和病理解剖学及生理学、发育中大脑的诊断解读、针对性管理干预、家庭咨询与预后评估以及长期预后优化的理解。例如,先天性心脏病神经损伤的护理强调将全生命周期的医学教育纳入其中。此外,需要入住新生儿重症监护病房(NICU)并接受护理的新生儿更有可能在未来需要儿科重症监护病房(PICU)的护理,并由神经重症监护医护人员提供服务。此外,患有神经损伤或有神经损伤风险的新生儿并非仅入住新生儿病房。涵盖胎儿和新生儿神经学的全年龄段教育,对于学员理解潜在疾病过程、管理及后遗症很有价值,并能促进儿科神经重症监护领域的发展。