Related Experiment Video

Updated: Nov 7, 2025

Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device
07:41

Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device

Published on: July 20, 2022

2.1K

Compassionate Deactivation of Pediatric Ventricular Assist Devices: A Review of 14 Cases

Seth A Hollander1, Beth D Kaufman1, Christine Bui1

  • 1Department of Pediatrics (Cardiology), Stanford University School of Medicine (S.A.H., B.D.K., C.B., L.S., K.R.R., D.N.R.), Palo Alto, California, USA.

Journal of Pain and Symptom Management
|April 28, 2021
PubMed

Insights

Compassionate deactivation (CD) of ventricular assist device (VAD) support is a common end-of-life option for children, often due to noncardiac issues. Discussions involve both caregivers and medical teams, leading to withdrawal of other life support.

Area of Science:

  • Pediatric Cardiology
  • Palliative Care
  • Medical Ethics

Background:

  • Compassionate deactivation (CD) of ventricular assist device (VAD) support is a recognized option for pediatric patients when the burdens of therapy outweigh the benefits.
  • VADs are increasingly used in children with end-stage heart failure, necessitating clear end-of-life care protocols.

Purpose of the Study:

  • To determine the prevalence, indications, and outcomes of compassionate deactivation (CD) in children supported by VADs at the end of life.
  • To analyze the factors contributing to the decision for CD and the process of its implementation.

Main Methods:

  • A retrospective review of pediatric VAD cases at a single institution from 2011 to 2020 was conducted.
  • Cases were specifically identified as CD, excluding deaths during resuscitation, brain death, or from non-survivable brain injury prior to deactivation.

Main Results:

  • Compassionate deactivation (CD) accounted for 58% of deaths among pediatric VAD patients (14 out of 24).
  • Indications for CD were multifactorial, including end-organ injury, infection, and stroke, often occurring after a median of 40 days on support.
  • CD involved withdrawal of ventilatory and inotropic support in 86% of cases, with death occurring within a median of 10 minutes.

Conclusions:

  • Compassionate deactivation (CD) is the predominant mode of death in pediatric VAD non-survivors, frequently driven by noncardiac complications.
  • Both caregivers and medical providers initiate CD discussions, highlighting shared decision-making in end-of-life care.
  • The process often involves discontinuing other life-sustaining treatments, leading to a rapid decline and death.
Abstract

Keywords:
Ventricular assistcompassionate deactivationend-of-lifeheart failurepalliativepediatric

More Related Videos

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock06:10

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Published on: June 12, 2021

3.4K
Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock07:39

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock

Published on: August 16, 2021

3.8K

Related Concept Videos

Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
102
Cardiopulmonary Resuscitation III: AED Use01:23

Cardiopulmonary Resuscitation III: AED Use

Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
199
Mechanical Ventilation II: Invasive Ventilation01:23

Mechanical Ventilation II: Invasive Ventilation

Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
405
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
118
Mechanical Ventilation III: Noninvasive Ventilation01:23

Mechanical Ventilation III: Noninvasive Ventilation

Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...
348
Cardiopulmonary Resuscitation I: Adult01:21

Cardiopulmonary Resuscitation I: Adult

Cardiopulmonary resuscitation, or CPR, is a life-saving emergency procedure performed when a person's heart has stopped beating or they are no longer breathing. The foundation of CPR is Basic Life Support (BLS), which focuses on the early recognition of cardiac arrest, the immediate start of high-quality chest compressions, and the timely use of an automated external defibrillator (AED).Assessing Responsiveness and Checking the Carotid PulseWhen approaching an unresponsive person, first ensure...
255