Medical missions for the provision of paediatric cardiac surgery in low- and middle-income countries

被引:12
作者
Molloy, Frank J. [1 ]
Nguyenvu Nguyen [2 ]
Mize, Marisa [3 ,4 ]
Wright, Gavin [5 ,6 ]
George-Hyslop, Cecilia St. [7 ,8 ]
O'Callaghan, Maura [9 ]
Scanlan, Emma [6 ]
Novick, William M. [1 ,10 ]
机构
[1] William Novick Global Cardiac Alliance, Memphis, TN USA
[2] Banner Childrens, Cardon Childrens Med Ctr, Pediat Cardiac Intens Care, Mesa, AZ USA
[3] Por Cristo, Boston, MA USA
[4] Childrens Natl Med Ctr, Pediat Crit Care, Washington, DC 20010 USA
[5] Royal Brompton & Harefield NHS Fdn Trust, Crit Care & Anaesthesia, London, England
[6] Chain Hope, London, England
[7] Hosp Sick Children, Cardiac Crit Care Unit, Labatt Family Heart Ctr, Toronto, ON, Canada
[8] Univ Toronto, Toronto, ON, Canada
[9] Great Ormond St Hosp NHS Fdn Trust, Cardiac Crit Care & Resp Div, London, England
[10] Univ Tennessee, Hlth Sci Ctr, Surg & Int Child Hlth, Memphis, TN USA
关键词
CHD; international medicine; non-governmental aid organisations; CONGENITAL HEART-SURGERY; CELL TRANSFUSION STRATEGIES; INTENSIVE-CARE; CARDIOTHORACIC SURGERY; DEVELOPING-WORLD; PATIENT SAFETY; SEPTAL-DEFECTS; OPERATING-ROOM; BLOOD; CHILDREN;
D O I
10.1017/S104795111700261X
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
This review will outline the role of visiting cardiac surgical teams in low- and middle-income countries drawing on the collective experience of the authors in a wide range of locations. Requests for assistance can emerge from local programmes at a beginner or advanced stage. However, in all circumstances, careful pre-trip planning is necessary in conjunction with clinical and non-clinical local partners. The clinical evaluation, surgical procedures, and postoperative care all serve as a template for collaboration and education between the visiting and local teams in every aspect of care. Education focusses on both common and patient-specific issues. Case selection must appropriately balance the clinical priorities, safety, and educational objectives within the time constraints of trip duration. Considerable communication and practical challenges will present, and clinicians may need to make significant adjustments to their usual practice in order to function effectively in a resource-limited, unfamiliar, and multilingual environment. The effectiveness of visiting trips should be measured and constantly evaluated. Local and visiting teams should use data-driven evaluations of measurable outcomes and critical qualitative evaluation to repeatedly re-assess their interim goals. Progress invariably takes several years to achieve the final goal: an autonomous self-governing, self-financed, cardiac programme capable of providing care for children with complex CHD. This outcome is consistent with redundancy for the visiting trips model at the site, although fraternal, professional, and academic links will invariably remain for many years.
引用
收藏
页码:S47 / S54
页数:8
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