Chest Compressions in Pediatric Patients With Continuous-Flow Ventricular Assist Devices: Case Series and Proposed Algorithm

Ivie D. Esangbedo, Priscilla Yu

Research output: Contribution to journalArticlepeer-review

Abstract

Patients with continuous flow ventricular assist devices (CF-VAD's) in the systemic ventricle (left ventricle or single ventricle) often have no palpable pulses, unreliable pulse oximetry waveforms and non-pulsatile arterial waveforms despite hemodynamic stability. When circulatory decompensation occurs, standard indicators to begin cardiopulmonary resuscitation (CPR) which are used in other pediatric patients (i.e., significant bradycardia or loss of pulse) cannot be applied in the same fashion. In this population, there may already be pulselessness and development of bradycardia in and of itself would not trigger chest compressions. There are no universal guidelines to dictate when to consider chest compressions in this population. As such, there may be a delay in decision-making or in recognizing the need for chest compressions, even in patients hospitalized in intensive care units (ICU) and cared for by experienced staff who perform CPR regularly. We present four examples of pediatric cardiac ICU patients from a single center who underwent CPR between 2018 and 2019. Based on this case series, we propose a decision-making algorithm for chest compressions in pediatric patients with CF-VADs in the systemic ventricle.

Original languageEnglish (US)
Article number883320
JournalFrontiers in Pediatrics
Volume10
DOIs
StatePublished - Jun 21 2022

Keywords

  • cardiac intensive care unit
  • cardiopulmonary resuscitation (CPR)
  • chest compression (CC)
  • continuous flow ventricular assist device
  • left ventricular assist device (LVAD)
  • pediatric
  • ventricular assist device (VAD)

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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