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Ventricular Assist Device Training and Emergency Management Among Pediatric Cardiac Intensive Care Physicians -

Ivie D Esangbedo1, Priscilla Yu2, Tarif A Choudhury3

  • 1Division of Critical Care Medicine, Department of Pediatrics, University of Washington, Seattle, WA, USA.

World Journal for Pediatric & Congenital Heart Surgery
|December 21, 2023
PubMed

Insights

Pediatric cardiac intensive care physicians lack clear guidelines for managing ventricular assist device (VAD) emergencies. A survey revealed a significant gap in resuscitation recommendations for VAD patients, highlighting the need for standardized emergency protocols.

Area of Science:

  • Pediatric Cardiology
  • Critical Care Medicine
  • Medical Device Management

Background:

  • Increasing numbers of pediatric ventricular assist device (VAD) patients require specialized care.
  • Pediatric cardiac intensive care units (CICUs) face growing VAD patient volumes and VAD-days.
  • Current practices for routine and emergency VAD management are not well-defined.

Purpose of the Study:

  • To investigate current practices in pediatric VAD management among CICU physicians.
  • To identify gaps in knowledge and training for emergency cardiovascular care in VAD patients.
  • To inform the development of much-needed resuscitation guidelines.

Main Methods:

  • A multicenter, cross-sectional survey was distributed to pediatric CICU physicians in the US and Canada.
  • The survey collected data on physician experience, training, comfort level, and management practices for VAD patients.
  • Response rate was 42.5% (108 of 254 physicians) from 26 institutions.

Main Results:

  • 86.1% of respondents received formal VAD management training (fellowship, simulation, conferences).
  • 72.2% of physicians felt comfortable or very comfortable managing pediatric VADs.
  • 37% of respondents had performed cardiopulmonary resuscitation (CPR) on a VAD patient, indicating a need for emergency protocols.

Conclusions:

  • A significant portion of pediatric VAD patients requiring CPR may not have standardized emergency care protocols.
  • The absence of international guidelines for emergency cardiovascular care in pediatric VAD patients is a critical gap.
  • Further research and guideline development are essential to ensure optimal outcomes for these complex patients.

Keywords:
cardiac intensive carecardiopulmonary resuscitationpediatric resuscitationventricular assist device

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