title: Medical and nursing care of the child on mechanical circulatory support.
abstract: OBJECTIVE
  To review the medical and nursing care of children receiving mechanical circulatory support as part of the Pediatric Cardiac Intensive Care Society/Extracorporeal Life Support Organization Joint Statement on Mechanical Circulatory Support. DATA SOURCES/STUDY SELECTION/DATA EXTRACTION/DATA SYNTHESIS: This is a general review of current issues of medical and nursing care of children on mechanical circulatory support. It consists of knowledge gained from practical experience combined with supporting evidence and/or discussion of controversies for which evidence exists or is inconclusive. The scope of this review includes assessment and monitoring, cardiovascular, pulmonary, and renal and fluid management, as well as infection prevention and treatment, neurological, and nutritional considerations. Physical and psychological care is discussed, as well as ethical and practical issues regarding termination of support.
  
  
  CONCLUSIONS
  There are unique aspects to the medical and nursing care of a patient requiring mechanical circulatory support. Preserving the possibility for cardiac recovery when possible and preventing damage to noncardiac organs are essential to maximizing the probability that patients will have quality survival following support with a mechanical circulatory support device.
authors.affiliation: The Labatt Family Heart Centre, Departments of Critical Care Medicine and Paediatrics, University of Toronto, The Hospital for Sick Children, Toronto, ON, Canada. steven.schwartz@sickkids.ca
authors.forename: Steven M
authors.initials: SM
authors.lastname: Schwartz
authors.forename: Alicia
authors.initials: A
authors.lastname: Schmidt
mesh_terms: D000203:Activities of Daily Living; D001243:Assisted Circulation / Q000009:adverse effects / Q000451:nursing* / Q000523:psychology; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002648:Child; D005066:Euthanasia, Passive / Q000941:ethics; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000451:nursing* / Q000523:psychology; D005440:Fluid Therapy; D006331:Heart Diseases / Q000451:nursing / Q000628:therapy*; D006801:Humans; D017053:Infection Control; D008991:Monitoring, Physiologic / Q000451:nursing; D009460:Neurologic Examination; D003668:Pressure Ulcer / Q000451:nursing / Q000517:prevention & control; D020521:Stroke / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000517:prevention & control; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D002316:Cardiotonic Agents; D014662:Vasoconstrictor Agents; D014665:Vasodilator Agents