Hehir David A, Niebler Robert A, Brabant Christopher C, Tweddell James S, Ghanayem Nancy S
Division of Pediatric Critical Care, Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA.
World J Pediatr Congenit Heart Surg. 2012 Jan 1;3(1):58-66. doi: 10.1177/2150135111420888.
Utilization of ventricular assist devices (VADs) in children is increasing, as is the complexity of patients supported. We review the intensive care management of pediatric patients with VAD in the perioperative and rehabilitation phases, highlighting the technical aspects and physiology of VADs which impact care. Indications for VAD placement and the preoperative assessment of risk are discussed. Specific aspects of postoperative and long-term care including device troubleshooting, hemostasis and anticoagulation, support of the right ventricle, incidence and prevention of neurologic injury, and other complications are reviewed.
儿童心室辅助装置（VAD）的使用正在增加，接受支持的患者情况也日益复杂。我们回顾了小儿VAD患者在围手术期和康复阶段的重症监护管理，重点介绍了影响护理的VAD技术方面和生理学知识。讨论了VAD植入的适应症和术前风险评估。还回顾了术后和长期护理的具体方面，包括设备故障排除、止血与抗凝、右心室支持、神经损伤的发生率及预防，以及其他并发症。
