Prevalence of Anemia and Iron Deficiency in Pediatric Patients on Ventricular Assist Devices

Area of Science:

• Pediatric cardiology
• Hematology
• Medical devices

Background:

• Anemia and iron deficiency are common in children requiring ventricular assist devices (VADs).
• Understanding these conditions in pediatric VAD patients is crucial for effective management.

Purpose of the Study:

• To determine the prevalence and characteristics of anemia and iron deficiency in pediatric VAD patients.
• To compare these indices between pulsatile VAD (P-VAD) and continuous-flow VAD (CF-VAD) support.

Main Methods:

• Retrospective review of pediatric patients (<21 years) on durable VAD support for ≥7 days.
• Evaluation of red blood cell (RBC) and iron deficiency indices at VAD implant and explant.
• Comparison of anemia and iron deficiency between P-VAD and CF-VAD groups.

Main Results:

• 48% of patients were anemic at VAD implant; 67% of CF-VAD patients had anemia versus 34% of P-VAD patients.
• Iron deficiency was present in 52% of patients at implant, with similar prevalence in both VAD types.
• Anemia prevalence increased to 71% at explant, with higher RBC transfusion volumes in P-VAD patients.

Conclusions:

• Anemia and iron deficiency are prevalent in pediatric VAD patients.
• Pulsatile VAD patients may develop anemia during VAD support.
• High RBC transfusion rates can mask microcytosis, highlighting the need for specific iron studies to diagnose iron deficiency.