Liu Jia, Graham Robert J, Jackson Shawn S
Department of Anesthesiology, Pain and Perioperative Medicine, Children's National Hospital, Washington, DC 20010, USA.
Department of Critical Care Medicine, Children's National Hospital, Washington, DC 20010, USA.
Children (Basel). 2025 Mar 26;12(4):417. doi: 10.3390/children12040417.
Caring for technology-dependent adolescents and young adults presents significant challenges, especially for procedural and peri-operative care. This review delves into the complexities of managing these patients before, during, and after major medical procedures or operations, highlighting the unique medical and psychosocial issues that demand specialized attention. We address the intricacies of pre-procedural assessment and optimization, as well as post-procedural management, with a particular focus on the challenges associated with life-sustaining technologies such as chronic ventilator dependence. Additionally, we explore medicolegal factors such as guardianship and surrogate decision-making, which are often more complex in this population. The review also identifies key areas of uncertainty that merit further research and exploration, aiming to enhance the quality of care and improve outcomes for technology-dependent individuals transitioning to adult healthcare.
照顾依赖技术的青少年和青年面临重大挑战,尤其是在程序护理和围手术期护理方面。本综述深入探讨了在重大医疗程序或手术之前、期间和之后管理这些患者的复杂性,强调了需要特别关注的独特医学和心理社会问题。我们阐述了术前评估与优化以及术后管理的复杂性,特别关注与维持生命技术(如长期依赖呼吸机)相关的挑战。此外,我们探讨了监护和替代决策等法医学因素,这些因素在这一人群中往往更为复杂。该综述还确定了值得进一步研究和探索的关键不确定领域,旨在提高护理质量,改善依赖技术的个体向成人医疗保健过渡的结局。