PEDS5: Single-Center Experience Improving Nutritional Outcomes in Pediatric Paracorporeal Ventricular Assist Device Recipients

Purpose: To describe and assess a comprehensive nutritional plan for children implanted with paracorporeal ventricular assist devices (VAD), given they are prone to early satiety, anorexia and nausea which potentially compromise their ability to heal and grow, on top of often already compromised nutritional status due to heart failure. Single-Center Experience Improving Nutritional Outcomes in Pediatric Paracorporeal Ventricular Assist Device Recipients Methods: Single-center retrospective review of consecutive pediatric patients implanted with paracorporeal VAD before (Dec 2010-June 2019) and after implementation (July 2019-Dec 2021) of a comprehensive, VAD-specific nutritional plan. The plan included targeted micronutrient repletion of vitamins A, C and D as well as zinc, registered dietician directed goal calories from fat, protein and carbohydrates, and minimization of nutrition interruption for planned procedures. Multidisciplinary reassessment occurred twice a week. Results: A total of 25 patients were identified with 8 implanted after implementation of the new nutritional plan (see Table). Pre- and post-groups were similar, but post-intervention group showed better overall survival (53% vs 100% survival). Micronutrient assessment showed abnormalities in 88% of the post-group that all normalized after 1 month, while micronutrient assessment was largely unknown in the pre-group. The post-group had fewer overall infections, fewer confirmed skin infections, and fewer days on steroids (for inflammation). Summary: The intensity of wound healing needed for pediatric paracorporeal VAD might be compared to similar needs as those with large abdominothoracic burn, and a similar approach to nutrition and wound healing is likely beneficial.