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A pediatric client in an adult ICU setting requiring a mechanical assist device and heart transplantation: case study
S Chucta1, S Vaupel-Juart, T Latimer
1Ohio State University Hospitals, Columbus.
Insights
This case study highlights the complex nursing care for a child requiring a biventricular assist device (BIVAD) and heart transplant in an adult ICU. It addresses critical issues like family adaptation, body image changes, and end-of-life grief.
Area of Science:
- Pediatric critical care medicine
- Cardiovascular surgery
- Nursing science
Background:
- Children with end-stage heart failure may require advanced mechanical circulatory support.
- Adult intensive care units (ICUs) can present unique challenges for pediatric patients.
Observation:
- An older school-age child was admitted to an adult ICU for biventricular assist device (BIVAD) implantation and subsequent heart transplantation.
- The case involved complex medical and psychosocial nursing considerations.
Findings:
- Nursing care focused on managing the BIVAD, preparing for heart transplantation, and addressing psychosocial needs.
- Key nursing issues included altered family processes, body image disturbances, and anticipatory grieving.
Implications:
- Highlights the need for specialized nursing protocols for pediatric patients with mechanical circulatory support in adult ICUs.
- Emphasizes the importance of a multidisciplinary approach to address the holistic needs of critically ill children and their families.
- Informs nursing practice regarding psychosocial support during advanced cardiac care and transplantation.
Abstract:
Intensive care unit nurses are often faced with challenging situations. This case study focuses on an older school-age child in an adult intensive care unit (ICU) for the placement of a biventricular assist device (BIVAD) and eventual heart transplantation. Discussion of the assist device and transplantation is included as well as a discussion of the nursing care issues. The care issues discussed include alteration in family processes, alteration in body image, and grieving related to the possibility of death.