tailieunhanh - Neurologic and cognitive outcomes in children with congenital heart disease

An example of a continuum of care in action is the Reproductive and Child Health II (RCH II) program, which uses an integrated model of health care and focuses on women’s and children’s health from birth through adulthood. With the goal of improving reproductive and child health in India, RCH II concentrates on family planning and maternal, newborn, child, and adoles- cent health services. The program focuses on community participation and empowering people to play an active role in their reproductive health care. The newborn and child health package includes the integrated management of neonatal and childhood illness (IMNCI) strategy, immunization, skilled care at birth, and infant and young. | Neurologic and cognitive outcomes in children with congenital heart disease William T. Mahle MD Advances in congenital heart surgery have resulted in the increased survival of infants born with complex congenital heart disease. Questions remain however about how these patients will develop and whether they will have normal productive lives. To date studies have shown that although the vast majority of children with congenital heart disease have normal outcomes as a group they generally have higher rates of neurodevelopmental problems. The developmental sequelae include mild problems in cognition attention and neuromotor functioning. The etiology of neurologic deficits in this population appears to be multifactorial with preoperative operative and postoperative factors all contributing to outcome. Continued research and attempts to minimize neurologic injury and associated sequelae are of primary importance. Recent data suggest that advances in care already may be improving outcome after congenital heart surgery. Ongoing documentation of the long-term outcome in this population needs to be mandated as does the implementation of environmental enrichment programs to help ameliorate the long-term consequences of congenital heart disease. Curr Opin Pediatr 2001 13 482-486 2001 Lippincott Williams Wilkins Inc. Sibley Heart Center Department of Pediatrics Emory University School of Medicine Atlanta Georgia USA. Correspondence to William T. Mahle MD Sibley Heart Center Egleston Children s Hospital 2040 Ridgewood Drive Atlanta GA 30322-1028 USA e-mail mahle@ Current Opinion in Pediatrics 2001 13 482-486 Abbreviations CHD congenital heart disease DHCA deep hypothermic circulatory arrest HLHS hypoplastic left heart syndrome ISSN 1040-8703 2001 Lippincott Williams Wilkins Inc. The last several decades have witnessed remarkable improvements in surgical outcome and long-term survival for children with congenital heart disease CHD . With an increasing number of .