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Pediatric Palliative Care in the Heart Failure, Ventricular Assist Device and Transplant Populations: Supporting Patients, Families and Their Clinical Teams.

Authors :
Hope KD
Bhat PN
Dreyer WJ
Elias BA
Jump JL
Santucci G
Afonso NS
Ninemire MR
Achuff BJ
Kritz EM
Gowda SH
Puri K
Source :
Children (Basel, Switzerland) [Children (Basel)] 2021 Jun 02; Vol. 8 (6). Date of Electronic Publication: 2021 Jun 02.
Publication Year :
2021

Abstract

Heart failure is a life-changing diagnosis for a child and their family. Pediatric patients with heart failure experience significant morbidity and frequent hospitalizations, and many require advanced therapies such as mechanical circulatory support and/or heart transplantation. Pediatric palliative care is an integral resource for the care of patients with heart failure along its continuum. This includes support during the grief of a new diagnosis in a child critically ill with decompensated heart failure, discussion of goals of care and the complexities of mechanical circulatory support, the pensive wait for heart transplantation, and symptom management and psychosocial support throughout the journey. In this article, we discuss the scope of pediatric palliative care in the realm of pediatric heart failure, ventricular assist device (VAD) support, and heart transplantation. We review the limited, albeit growing, literature in this field, with an added focus on difficult conversation and decision support surrounding re-transplantation, HF in young adults with congenital heart disease, the possibility of destination therapy VAD, and the grimmest decision of VAD de-activation.

Details

Language :
English
ISSN :
2227-9067
Volume :
8
Issue :
6
Database :
MEDLINE
Journal :
Children (Basel, Switzerland)
Publication Type :
Academic Journal
Accession number :
34199474
Full Text :
https://doi.org/10.3390/children8060468