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

Published online by Cambridge University Press:  12 March 2025

Melissa B. Jones Open the ORCID record for Melissa B. Jones [Opens in a new window] ,
Sherrill D. Caprarola Open the ORCID record for Sherrill D. Caprarola [Opens in a new window] ,
Sarah Schlatterer ,
Mandana O’Donnell ,
Cara Pleau ,
Katelyn Staso ,
Richard A. Jonas ,
Yves D’Udekem D’Acoz Open the ORCID record for Yves D’Udekem D’Acoz [Opens in a new window] ,
Ricardo Munoz  and
Jessica L. Carpenter
...Show all authors
Melissa B. Jones*
Affiliation:
Division of Cardiac Critical Care, Children’s National Hospital, Washington, DC, USA
Sherrill D. Caprarola
Affiliation:
Division of Cardiology, Children’s Hospital Colorado, Denver, CO, USA
Sarah Schlatterer
Affiliation:
Zickler Family Prenatal Pediatrics Institute at Children’s National Hospital, Children’s National Medical Center, Washington, DC, USA
Mandana O’Donnell
Affiliation:
Division of Physical Medicine and Rehabilitation, Children’s National Hospital, Washington, DC, USA
Cara Pleau
Affiliation:
Division of Nursing, Children’s National Hospital, Washington, DC, USA
Katelyn Staso
Affiliation:
Division of Neurology, Children’s National Hospital, Washington, DC, USA
Richard A. Jonas
Affiliation:
Division of Cardiac Surgery, Children’s National Hospital, Washington, DC, USA
Yves D’Udekem D’Acoz
Affiliation:
Division of Cardiac Surgery, Children’s National Hospital, Washington, DC, USA
Ricardo Munoz
Affiliation:
Division of Cardiac Critical Care, Children’s National Hospital, Washington, DC, USA
Jessica L. Carpenter
Affiliation:
Division of Pediatric Neurology, University of Maryland Medical System, Baltimore, MD, USA
Catherine Limperopolous
Affiliation:
Developing Brain Institute, Children’s National Hospital, Washington, DC, USA
Gil Wernovsky
Affiliation:
Division of Cardiac Critical Care, Children’s National Hospital, Washington, DC, USA Division of Pediatric Cardiology, Children’s National Hospital, Washington, DC, USA
*
Corresponding author: Melissa B. Jones; Email: [email protected]
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Abstract

Introduction:

Children with CHD are at increased risk for neurodevelopmental disabilities and neuropsychological impairments throughout their life span. The purpose of this report is to share our experience building a sustainable, novel, inpatient, interdisciplinary Neurocardiac Critical Care Program to mitigate risks and optimize outcomes during the ICU stay.

Material and methods:

A descriptive review was chosen to identify meaningful characteristics, challenges and lessons learned related to the establishment, expansion of and sustainability of Neurocardiac Critical Care Program in a 26-bed pediatric cardiac ICU.

Results:

We successfully launched, expanded, and sustained an interdisciplinary Neurocardiac Critical Care Program. Here, we share the foundation, framework, challenges, and lessons learned as we established and sustained the Neurocardiac Critical Care Program. The key elements of our program are (1) consistent engagement by pediatric neurologists in the cardiac ICU, (2) comprehensive education initiatives, (3) evidence-based clinical practice changes, and (4) quality improvement and research projects.

Discussion:

The development of a pediatric Neurocardiac Critical Care Program is feasible and sustainable. This program was informed by recent research related to perioperative and psychosocial risk factors that impact brain development and neurodevelopmental outcomes in this vulnerable population. By aligning our efforts, our multidisciplinary team is helping shift the paradigm in pediatric cardiac critical care to actively manage complex heart disease, while simultaneously and proactively mitigating risks to the developing brain and family unit.

Keywords

CHDneurodevelopmentbrain developmentbrain injurycardiac critical care
Type
Original Article
Information
Cardiology in the Young , First View , pp. 1 - 7
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Copyright
© The Author(s), 2025. Published by Cambridge University Press

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