Kohr L M, O'Brien P
Cardiovascular Program, Children's Hospital, Boston, Massachusetts, USA.
Nurs Clin North Am. 1995 Jun;30(2):261-90.
Although the general goals of therapy for the medical and nursing management of CHF in children have not changed in the last decade, advances have been made in understanding the unique characteristics of the neonatal heart and tailoring therapy to best support cardiac function (Table 6). In addition, strides have been made in manipulating the loading conditions of the ventricle to enhance cardiac output, which has fostered the development of new therapeutic agents and more aggressive treatment of these patients with improved outcomes. In situations in which the infant is unresponsive to therapy, surgical intervention is now done at an earlier age with good results. When surgery is not an option and the patient continues to deteriorate despite maximum medical management, mechanical support can be instituted as a bridge to transplantation.
尽管在过去十年中，儿童心力衰竭的医学和护理管理的总体治疗目标没有改变，但在了解新生儿心脏的独特特征以及调整治疗以最佳支持心脏功能方面取得了进展（表6）。此外，在控制心室负荷条件以提高心输出量方面也取得了进展，这促进了新治疗药物的开发，并对这些患者进行了更积极的治疗，结果得到改善。在婴儿对治疗无反应的情况下，现在手术干预的年龄更小，效果良好。当手术不是一种选择，且患者尽管接受了最大程度的药物治疗仍持续恶化时，可以采用机械支持作为移植的桥梁。
