Adverse events and ICU readmission rates after floor transfer for paediatric patients on ventricular assist device...

Area of Science:

• Pediatric Cardiology
• Mechanical Circulatory Support
• Critical Care Medicine

Background:

• Management of pediatric ventricular assist device (VAD) patients, including those with single ventricle anatomy, is increasingly occurring outside the intensive care unit (ICU).
• Assessing the safety and outcomes of non-ICU VAD management is crucial for optimizing patient care and resource allocation.

Purpose of the Study:

• To quantify adverse event rates and ICU readmissions for pediatric VAD patients transferred from the ICU to a general hospital floor.
• To compare outcomes between pediatric VAD patients with single ventricle anatomy and those with biventricular anatomy.

Main Methods:

• Retrospective chart review of 22 complex pediatric VAD patients (15 biventricular, 7 single ventricle) managed on the hospital floor.
• Data collection included adverse events, ICU readmissions, length of stay, and patient demographics.
• Berlin EXCOR VAD was the most utilized device.

Main Results:

• Nine patients (41%) experienced adverse events, with infection being the most common (1.8 events per patient-year).
• There were 9 ICU readmissions with a median length of stay of 2 days.
• Single ventricle patients showed a higher proportion of ICU readmissions and adverse events compared to biventricular patients.
• No deaths were reported during the study period.

Conclusions:

• Pediatric VAD patients can be safely managed on the hospital floor with low rates of ICU readmission.
• Adverse event rates in non-ICU settings are comparable to published data, suggesting feasibility of floor management.
• Close monitoring and management protocols are essential, particularly for single ventricle VAD patients.