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An overview of mechanical circulatory support in children

Robert D B Jaquiss1, Ronald A Bronicki

  • 1Department of Surgery, Duke Children's Hospital and Duke University School of Medicine, Durham, NC, USA. robert.jaquiss@duke.edu

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|June 6, 2013
PubMed

Insights

Mechanical circulatory support, including extracorporeal membrane oxygenation (ECMO) and ventricular assist devices (VADs), offers life-sustaining therapy for children with severe heart failure. Device selection depends on illness severity, recovery potential, and support duration needs.

Area of Science:

  • Pediatric Cardiology
  • Mechanical Circulatory Support

Background:

  • Severe pediatric heart failure often necessitates advanced interventions when medical management fails.
  • Mechanical circulatory support (MCS) provides life-sustaining therapy for these critical patients.

Purpose of the Study:

  • To review extracorporeal membrane oxygenation (ECMO) and ventricular assist devices (VADs) for pediatric severe heart failure.
  • To discuss indications, contraindications, timing, and device selection for ECMO and VADs.

Main Methods:

  • Literature search of PubMed using keywords: ECMO, extracorporeal membrane oxygenation, VAD, ventricular assist device, and pediatric.
  • Review of case reports, single-center series, multicenter studies, and registry reports.

Main Results:

  • ECMO and VADs are critical life-sustaining therapies for pediatric heart failure.
  • Both modalities have distinct advantages and disadvantages and can be used sequentially.

Conclusions:

  • ECMO and VADs can serve as bridge-to-transplant or bridge-to-recovery options.
  • Device choice and timing are guided by patient acuity, comorbidities, recovery potential, and expected support duration.
Abstract

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