ASAIO journal : a peer-reviewed journal of the American Society for Artificial Internal Organs
-
Discharging children on ventricular assist device (VAD) support offers advantages for quality of life. We sought to describe discharge and readmission frequency in children on VAD support. All VAD-implanted patients aged 10-21 years at Advanced Cardiac Therapies Improving Outcomes Network (ACTION) centers were identified from the Pediatric Health Information System database (2009-2018). ⋯ Discharge of children on VAD support has increased over time, although variability exists across centers. Readmissions are common with diverse indications; however, the risk of mortality is low. Further interventions, including collaboration in ACTION, are critical to increasing discharges and optimizing outpatient management.
-
Venovenous extracorporeal membrane oxygenation (VV ECMO) can successfully support patients with refractory respiratory failure and is widely accepted as a bridge to recovery or bridge to transplantation. However, some problems hinder success. Recirculation, an innate complication of VV ECMO, hamper efficient oxygenation. ⋯ Compared to VV ECMO, it has advantages of hemodynamic support, elimination of recirculation, and facilitation of rehabilitation. In the present case, we overcame recirculation and impending RV failure by applying OxyRVAD to patient who was initially managed with VV ECMO. He underwent lung transplantation after about 6 months of OxyRVAD support with active rehabilitation, the longest maintenance period ever known.