Building a sustainable neurocardiac critical care program in a paediatric cardiac ICU: insights and lessons learned

Area of Science:

• Pediatric Cardiology
• Pediatric Neurology
• Critical Care Medicine

Background:

• Children with congenital heart disease (CHD) face heightened risks of neurodevelopmental disabilities.
• These impairments can persist throughout their lifespan, impacting quality of life.
• Optimizing neurological outcomes in the intensive care unit (ICU) is crucial for this population.

Purpose of the Study:

• To describe the establishment and sustainability of a novel, inpatient, interdisciplinary Neurocardiac Critical Care Program.
• To share experiences, challenges, and lessons learned in developing this specialized program.
• To mitigate neurodevelopmental risks and optimize outcomes for pediatric cardiac patients in the ICU.

Main Methods:

• A descriptive review was conducted to analyze the program's development and sustainability.
• The study focused on a 26-bed pediatric cardiac ICU setting.
• Key characteristics, challenges, and lessons learned were identified.

Main Results:

• The interdisciplinary Neurocardiac Critical Care Program was successfully launched, expanded, and sustained.
• Key program elements include pediatric neurologist engagement, education, evidence-based practice changes, and quality improvement initiatives.
• The program demonstrated feasibility and sustainability in managing complex pediatric cardiac cases.

Conclusions:

• Developing a pediatric Neurocardiac Critical Care Program is feasible and sustainable.
• The program proactively addresses perioperative and psychosocial risk factors affecting brain development.
• This multidisciplinary approach shifts the paradigm to actively manage cardiac conditions while protecting neurodevelopmental outcomes and supporting families.