COGNITIVE COMPONENT IN THE REHABILITATION OF PRESCHOOL CHILDREN WITH CONGENITAL HEART DEFECTS. LITERATURE REVIEW.

Abstract

Introduction: Advancements in prenatal diagnostics, cardiac surgery, and intensive care have markedly increased the survival rates among children with complex congenital heart defects (CHD). Recent neuropsychological studies have convincingly demonstrated that children with CHD are at high risk of developing cognitive impairments. Aım: to analyze the literature data on the role of the cognitive component in the rehabilitation of preschoolers with congenital heart defects. Search strategy: as part of the preparation of the literature review, a multi-stage strategy for searching for scientific information was implemented using the following databases and platforms: PubMed, Google Scholar and UpToDate. Based on the results of the search, 71 scientific publications were selected that are most relevant to the purpose and subject of the study with a search time interval spanning the last 10 years. Results: The cognitive functioning of a child is one of the most vulnerable areas in the presence of congenital heart disease, which affects not only due to the pathology itself, but also due to mandatory cardiac surgery. Despite the growing attention to this problem, the prevalence of cognitive impairment in children and adolescents with congenital heart abnormalities is still underestimated and insufficiently reflected in clinical practice. Disorders of neurodevelopment in CHD are caused by a complex interaction of factors acting at various stages, starting from the antenatal period and ending with postoperative recovery. Predictors of cognitive impairment include both organic (including chronic hypoxia and cerebral hypoperfusion) and iatrogenic effects (for example, artificial blood circulation, anesthesia, and postoperative complications). Conclusions: In a number of countries, there are no structured monitoring and support programs for children with CHD after surgical treatment, routine assessment of cognitive and psycho-emotional development is not carried out, and there are not enough specialists who know the methods of neuropsychological diagnosis and correction.