{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:51:58Z","timestamp":1783731118958,"version":"3.55.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Congenital heart disease (CHD) in pediatric patients requires comprehensive care to address complex medical and psychological needs. Traditional approaches may lack the structure and coordination to optimize recovery fully. This study evaluates the association of Bundled Care Interventions, a structured multidisciplinary approach, in improving clinical outcomes and quality of life in pediatric CHD patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>A retrospective evaluation was conducted at our hospital from January 2021 to December 2023. Pediatric patients (<jats:italic>n<\/jats:italic>\u2009=\u2009136) under 14 years of age diagnosed with CHD were included, with 70 receiving Bundled Care Interventions (observation group) and 66 receiving conventional care (control group). The bundled care model included preoperative education, optimized intraoperative management, personalized postoperative rehabilitation, home-based care, and medication management. Primary outcome measures included oxygenation status, quality of life, adverse events, and complications. Statistical analyses were performed using independent <jats:italic>t<\/jats:italic>-tests and chi-square tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients in the Bundled Care Interventions group showed significant improvements in oxygenation (PaO<jats:sub>2<\/jats:sub> and FiO<jats:sub>2<\/jats:sub>; <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001) and quality of life across all dimensions (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001) compared to the control group. Additionally, adverse event incidence was lower in the observation group (4.29% vs. 15.2%; <jats:italic>p<\/jats:italic>\u2009=\u20090.031), as was the incidence of postoperative complications (5.71% vs. 18.2%; <jats:italic>p<\/jats:italic>\u2009=\u20090.024).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Bundled Care Interventions might improve oxygenation levels, enhance quality of life, and reduce adverse events and complications in pediatric CHD patients. This structured, multidisciplinary approach could offer a promising model for optimizing clinical outcomes and supporting comprehensive rehabilitation in this vulnerable population.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2025.1525020","type":"journal-article","created":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T07:13:02Z","timestamp":1741072382000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of bundled care interventions in improving outcomes for pediatric patients with congenital heart disease: a retrospective clinical evaluation"],"prefix":"10.3389","volume":"13","author":[{"given":"Li","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Ting","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1016\/j.pop.2021.04.005","article-title":"Congenital heart disease","volume":"48","author":"Scott","year":"2021","journal-title":"Prim Care"},{"key":"B2","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1016\/j.pop.2023.07.007","article-title":"Congenital heart disease","volume":"51","author":"Dotson","year":"2024","journal-title":"Prim Care"},{"key":"B3","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1097\/HCO.0000000000001054","article-title":"Assessment and management of neonates with unrepaired congenital heart disease","volume":"38","author":"Kohbodi","year":"2023","journal-title":"Curr Opin Cardiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2183","DOI":"10.1161\/01.cir.0000437597.44550.5d","article-title":"Diagnosis and treatment of fetal cardiac disease: a scientific statement from the American heart association","volume":"129","author":"Donofrio","year":"2014","journal-title":"Circulation"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e31184","DOI":"10.1097\/MD.0000000000031184","article-title":"Effect of comprehensive nursing intervention for congenital heart disease in children: a meta-analysis.","volume":"101","author":"Ding","year":"2022","journal-title":"Medicine"},{"key":"B6","doi-asserted-by":"publisher","first-page":"102","DOI":"10.12968\/bjon.2021.30.2.102","article-title":"Congenital heart disease in children","volume":"30","author":"Gowland","year":"2021","journal-title":"Br J Nurs"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1649","DOI":"10.1017\/S1047951122002979","article-title":"The effect of nursing care and follow-up for mothers of infants undergoing congenital heart surgery: a quasi-experimental study","volume":"33","author":"Ay","year":"2023","journal-title":"Cardiol Young"},{"key":"B8","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1891\/NN-2021-0028","article-title":"Preoperative care of neonates with congenital heart disease","volume":"41","author":"Tran","year":"2022","journal-title":"Neonatal Netw"},{"key":"B9","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1016\/j.pedn.2017.05.007","article-title":"Developmentally supportive care in congenital heart disease: a concept analysis","volume":"36","author":"Peterson","year":"2017","journal-title":"J Pediatr Nurs"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.pedhc.2022.08.006","article-title":"Pediatric nurse practitioners in adult congenital heart disease care","volume":"37","author":"Stromberg","year":"2023","journal-title":"J Pediatr Health Care"},{"key":"B11","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"61","author":"von Elm","year":"2008","journal-title":"J Clin Epidemiol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"2622","DOI":"10.1161\/01.cir.0000436140.77832.7a","article-title":"Prevention and treatment of thrombosis in pediatric and congenital heart disease: a scientific statement from the American heart association","volume":"128","author":"Giglia","year":"2013","journal-title":"Circulation"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1161\/CIR.0b013e318265ee8a","article-title":"Neurodevelopmental outcomes in children with congenital heart disease: evaluation and management: a scientific statement from the American heart association","volume":"126","author":"Marino","year":"2012","journal-title":"Circulation"},{"key":"B14","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1017\/S1047951116001955","article-title":"Guidelines for the management of congenital heart diseases in childhood and adolescence","volume":"27","year":"2017","journal-title":"Cardiol Young"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1569","DOI":"10.1007\/s00246-020-02413-z","article-title":"Establishing a comprehensive pediatric cardiac fitness and rehabilitation program for congenital heart disease","volume":"41","author":"Gauthier","year":"2020","journal-title":"Pediatr Cardiol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1718","DOI":"10.1017\/S1047951122003080","article-title":"Family-centered care and acute care cardiology: borrowing lessons from other disciplines","volume":"32","author":"Gal","year":"2022","journal-title":"Cardiol Young"},{"key":"B17","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1177\/152692481102100108","article-title":"A family-centered educational program to promote independence in pediatric heart transplant recipients","volume":"21","author":"Lawrence","year":"2011","journal-title":"Prog Transplant"},{"key":"B18","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1253\/circj.CJ-66-0083","article-title":"Guidelines for drug therapy in pediatric patients with cardiovascular diseases (JCS 2012). Digest version","volume":"78","year":"2014","journal-title":"Circ J"},{"key":"B19","first-page":"1","article-title":"Pharmacological therapy in pediatric cardiology","volume-title":"Pediatric Cardiology: Fetal, Pediatric, and Adult Congenital Heart Diseases","author":"Severin","year":"2020"},{"key":"B20","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1097\/00005650-199902000-00003","article-title":"The PedsQL: measurement model for the pediatric quality of life inventory","volume":"37","author":"Varni","year":"1999","journal-title":"Med Care"},{"key":"B21","doi-asserted-by":"publisher","first-page":"951","DOI":"10.1007\/s10198-021-01300-5","article-title":"Different levels of care for follow-up of adults with congenital heart disease: a cost analysis scrutinizing the impact on medical costs, hospitalizations, and emergency department visits","volume":"22","author":"Willems","year":"2021","journal-title":"Eur J Health Econ"},{"key":"B22","first-page":"16","article-title":"A comparative study of family centered nursing mode and routine clinical nursing mode on postoperative nursing of children with congenital heart disease","volume":"70","author":"Feng","year":"2020","journal-title":"J Pak Med Assoc"},{"key":"B23","doi-asserted-by":"publisher","first-page":"e0213154","DOI":"10.1371\/journal.pone.0213154","article-title":"Home care experience and nursing needs of caregivers of children undergoing congenital heart disease operations: a qualitative descriptive study","volume":"14","author":"Ni","year":"2019","journal-title":"PLoS One"},{"key":"B24","doi-asserted-by":"publisher","first-page":"157","DOI":"10.4037\/ajcc2023155","article-title":"Bloodstream infections in infants and children with congenital heart disease undergoing cardiac surgery","volume":"32","author":"Ward","year":"2023","journal-title":"Am J Crit Care"},{"key":"B25","doi-asserted-by":"publisher","first-page":"e66","DOI":"10.1016\/j.pedn.2024.06.021","article-title":"The effects of a hospital-to-home care transition program on perceived stress and readiness for hospital discharge in mothers of children with congenital heart disease undergoing corrective surgery","volume":"78","author":"Komijani","year":"2024","journal-title":"J Pediatr Nurs"},{"key":"B26","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1053\/jpdn.2001.26572","article-title":"Primary care in children with congenital heart disease","volume":"16","author":"Smith","year":"2001","journal-title":"J Pediatr Nurs"},{"key":"B27","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1111\/jcap.12265","article-title":"Self-care status in children with congenital heart disease: a mixed-method study","volume":"33","author":"Nematollahi","year":"2020","journal-title":"J Child Adolesc Psychiatr Nurs"},{"key":"B28","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/S0095-5108(05)70076-2","article-title":"Nursing considerations of the neonate with congenital heart disease","volume":"28","author":"Merle","year":"2001","journal-title":"Clin Perinatol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"e125","DOI":"10.1016\/j.pedn.2023.07.022","article-title":"SSSH: responsive soothing bassinet feasibility study for infants with congenital heart disease after cardiac surgery","volume":"73","author":"Lysaught","year":"2023","journal-title":"J Pediatr Nurs"},{"key":"B30","first-page":"47","article-title":"Effect of a systematic discharge nursing plan on mothers\u2019 knowledge and confidence in caring for infants with congenital heart disease at home","volume":"103","author":"Yang","year":"2004","journal-title":"J Formos Med Assoc"},{"key":"B31","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/s12887-023-04422-2","article-title":"The protocol of enhanced recovery after cardiac surgery (ERACS) in congenital heart disease: a stepped wedge cluster randomized trial","volume":"24","author":"Dou","year":"2024","journal-title":"BMC Pediatr"},{"key":"B32","doi-asserted-by":"publisher","first-page":"2521","DOI":"10.1017\/S1047951123000525","article-title":"Developmental care pathway for hospitalised infants with CHD: on behalf of the cardiac newborn neuroprotective network, a special interest group of the cardiac neurodevelopmental outcome collaborative","volume":"33","author":"Lisanti","year":"2023","journal-title":"Cardiol Young"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1525020\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T07:13:05Z","timestamp":1741072385000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1525020\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,4]]},"references-count":32,"alternative-id":["10.3389\/fped.2025.1525020"],"URL":"https:\/\/doi.org\/10.3389\/fped.2025.1525020","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,4]]},"article-number":"1525020"}}