Variation in Cardiac Rehabilitation for Pediatric Ventricular Assist Device Recipients Across North America

被引:6
作者
Burstein, Danielle S. [1 ]
McBride, Michael [1 ]
Lorts, Angela [2 ]
Rosenthal, David [3 ]
Peng, David M. [4 ]
Lantz, Jodie [5 ]
Tunuguntla, Hari [6 ]
Zinn, Matthew [7 ]
Curran, Tracy [8 ]
Wittekind, Samuel [2 ]
机构
[1] Childrens Hosp Philadelphia, Div Cardiol, 34th St & Civ Ctr Blvd, Philadelphia, PA 19104 USA
[2] Cincinnati Childrens Hosp, Div Cardiol, Cincinnati, OH USA
[3] Lucile Packard Childrens Hosp, Div Cardiol, Palo Alto, CA USA
[4] CS Mott Childrens Hosp, Div Cardiol, Ann Arbor, MI USA
[5] Childrens Hlth Dallas, Div Cardiol, Dallas, TX USA
[6] Texas Childrens Hosp, Div Cardiol, Houston, TX 77030 USA
[7] Childrens Hosp Pittsburgh, Div Cardiol, Pittsburgh, PA 15213 USA
[8] Boston Childrens Hosp, Dept Cardiol, Boston, MA USA
关键词
cardiac rehabilitation; exercise testing; pediatric; ventricular assist device; HEART-FAILURE; FUNCTIONAL STATUS; EXERCISE; CHILDREN; HEALTH; TRANSPLANTATION; SAFETY;
D O I
10.1097/MAT.0000000000001335
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
Despite increasing utilization of continuous-flow pediatric ventricular assist devices (VAD) in children, data on exercise testing and cardiac rehabilitation (CR) are unknown. We described variation in CR practices and identified barriers to exercise testing and CR. A survey was performed through the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) representing pediatric VAD centers across North America. Descriptive statistics were performed. A multidisciplinary cohort of 52 respondents from 28 pediatric VAD centers responded. Although 38% reported performing exercise testing, most (65%) used 6 minute walk tests rather than formal cycle or treadmill exercise testing. While all respondents refer to physical therapy during the initial inpatient stay for VAD placement, only 52% refer to a CR program. When performed, CR was performed at an ACTION center (84%), a local specialized center (21%), or a home-based CR program (26%). Commonly cited barriers to either CR or exercise testing were inadequate resources, inadequate implementation logistics knowledge, concerns about safety, inability of patients to travel to a CR facility, and concern about utility of exercise testing or CR. Over 90% of centers were interested in implementing a standardized pediatric VAD CR program. Utilization of exercise testing and CR after VAD placement is variable. Despite perceived barriers, most pediatric VAD centers are interested in implementing a standardized CR program for recipients. In response to this interest, we plan to implement a standardized CR protocol to all ACTION pediatric VAD centers in an effort to improve pretransplant waitlist rehabilitation and post-transplant outcomes.
引用
收藏
页码:1045 / 1050
页数:6
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