CARING FOR PEDIATRIC HEART FAILURE PATIENT WITH LONG-TERM MECHANICAL CIRCULATORY SUPPORT

Hyotala K. Crit Care Nurse 2018;38(5):44-57.

Although not a research article, this article gives current knowledge on long-term mechanical circulatory support for children awaiting cardiac transplantation surgery. Children may experience cardiac failure related to cardiomyopathy, rhythm disorders, infections such as myocarditis or Kawasaki disease, or congenital defects that cannot be surgically repaired. Long-term mechanical circulatory support in children has developed at a slower pace compared with the adult population related to the unique issues children present such as size and variations in their cardiac anatomy. Long-term mechanical circulatory support is implanted for various reasons and can be implanted for months or possibly years until a donor heart becomes available or the patient's heart improves. Long-term mechanical circulatory support can restore cardiac output and organ perfusion and help alleviate other symptoms of cardiac failure while reducing the need for inotropic support.

Critical care nurses must be well versed in caring for children with a long-term mechanical circulatory support device as their use is increasing. The author gives information on the 4 most common devices that are often used for pediatric heart failure. In addition, she provides important clinical applications for nursing care of these patients including assessment of patient perfusion and device function; preparation for emergencies; prevention of adverse events-most commonly seen are device malfunction, infection, neurological dysfunction, and bleeding; aid in activities of daily living; and promotion of quality of life for these children and their families.