Perioperative management of pediatric patients on mechanical cardiac support

Area of Science:

• Pediatric Cardiology
• Anesthesiology
• Medical Device Technology

Background:

• The number of children with end-stage heart failure requiring mechanical circulatory support (MCS) is increasing.
• These pediatric patients necessitate anesthetic management for diverse medical procedures, including diagnostic imaging, interventions, and noncardiac surgeries.
• Safe perioperative care for these complex patients is a growing concern.

Purpose of the Study:

• To review the demographics of pediatric patients on mechanical cardiac support.
• To discuss the various types of mechanical circulatory support devices available for children.
• To outline key concepts for the safe perioperative management of these patients.

Main Methods:

• This article is a comprehensive literature review.
• Focus is placed on short- and long-term cardiac support devices, excluding extracorporeal membrane oxygenation for respiratory indications.
• The review synthesizes information on patient populations, device characteristics, and anesthetic considerations.

Main Results:

• Growing pediatric population with end-stage heart failure relies on MCS.
• A range of MCS devices are available for pediatric use.
• Critical perioperative management strategies are essential for patient safety.

Conclusions:

• Pediatric patients on mechanical circulatory support represent a unique and expanding population.
• Understanding available devices and implementing tailored perioperative anesthetic care are crucial for successful outcomes.
• Further research into optimizing anesthetic management for this group is warranted.