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Medical and Nursing Care of the Child on Mechanical Circulatory Support

Schwartz, Steven M. MD, FRCPC1; Schmidt, Alicia MSN2

Pediatric Critical Care Medicine:
doi: 10.1097/PCC.0b013e318292dfdc
Joint Statement on Mechanical Circulatory Support
Abstract

Objectives: To review the medical and nursing care of children receiving mechanical circulatory support as part of the Pediatric Cardiac Intensive Care Society/Extracorporeal Life Support Organization Joint Statement on Mechanical Circulatory Support.

Data Sources/Study Selection/Data Extraction/Data Synthesis: This is a general review of current issues of medical and nursing care of children on mechanical circulatory support. It consists of knowledge gained from practical experience combined with supporting evidence and/or discussion of controversies for which evidence exists or is inconclusive. The scope of this review includes assessment and monitoring, cardiovascular, pulmonary, and renal and fluid management, as well as infection prevention and treatment, neurological, and nutritional considerations. Physical and psychological care is discussed, as well as ethical and practical issues regarding termination of support.

Conclusions: There are unique aspects to the medical and nursing care of a patient requiring mechanical circulatory support. Preserving the possibility for cardiac recovery when possible and preventing damage to noncardiac organs are essential to maximizing the probability that patients will have quality survival following support with a mechanical circulatory support device.

Author Information

1The Labatt Family Heart Centre, Departments of Critical Care Medicine and Paediatrics, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada.

2ECMO Program, Phoenix Children’s Hospital, Phoenix, AZ.

The authors have disclosed that they do not have any potential conflicts of interest.

For information regarding this article, E-mail: steven.schwartz@sickkids.ca

©2013The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies