Nursing care in a pediatric patient with Berlin Heart Excor® ventricular assist device: A case report

Abstract

Introduction

Pediatric heart transplantation is the treatment of choice for advanced heart failure. Due to the scarcity of donor organs, the use of mechanical circulatory support devices as a bridge to transplantation has increased. The Berlin Heart Excor® (BHE) is the most widely used ventricular assist device in the pediatric population.

Objective

To describe a comprehensive, family-centered nursing approach in an infant with severe heart failure who required the simultaneous use of extracorporeal membrane oxygenation (ECMO) and a BHE ventricular assist device.

Case description

A 13-month-old infant was admitted to the pediatric intensive care unit with acute myocarditis and severe biventricular dysfunction. The patient developed hemodynamic deterioration requiring ECMO support followed by left ventricular assistance with a Berlin Heart Excor®, with both devices coexisting for 2 days. After a favorable clinical course, progressive weaning from the device was initiated, and it was removed after 51 days, followed by hospital discharge.

Care plan

The nursing process was applied based on Virginia Henderson's conceptual model, using NANDA-International, Inc. (NANDA-I) taxonomy, the Nursing Outcomes Classification (NOC), and the Nursing Interventions Classification (NIC). Care focused on addressing the psychosocial needs of both the patient and their family.

Conclusions

The systematic application of the nursing process enabled the structuring of complex care and the evaluation of its effectiveness. Family-centered care proved essential for adaptation to the disease process and for the recovery of the pediatric patient.