PMID- 29107545
OWN - NLM
STAT- MEDLINE
DCOM- 20191127
LR  - 20191127
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Print)
IS  - 1053-2498 (Linking)
VI  - 37
IP  - 1
DP  - 2018 Jan
TI  - Infectious complications of ventricular assist device use in children in the 
      United States: Data from the Pediatric Interagency Registry for Mechanical 
      Circulatory Support (Pedimacs).
PG  - 46-53
LID - S1053-2498(17)32028-4 [pii]
LID - 10.1016/j.healun.2017.09.013 [doi]
AB  - BACKGROUND: Infections are frequent in pediatric ventricular assist device (VAD) 
      patients. In this study we aimed to describe infections in durable VAD patients 
      reported to Pedimacs. METHODS: Durable VAD data from the Pedimacs registry 
      (September 19, 2012 to December 31, 2015) were analyzed. Infections were 
      described with standard descriptive statistics, Kaplan-Meier analysis and 
      competing outcomes analysis. RESULTS: There were 248 implants in 222 patients, 
      with a mean age and a median follow-up of 11 +/- 6.4 years and 2.4 patient-months 
      (<1 day to 2.6 years), respectively. Device types were pulsatile flow (PF) in 91 
      (41%) patients and continuous flow (CF) in 131 (59%) patients. PF patients were 
      younger (4 +/- 4 vs 14 +/- 4 years; p < 0.0001) and were more likely to have 
      congenital heart disease (25% vs 12%; p = 0.03), prior surgery (53% vs 26%; p < 
      0.0001) and prior extracorporeal membrane oxygenation (24% vs 7%; p = 0.0003). 
      Infection accounted for 17% (96 of 564) of the reported adverse events (AEs). A 
      non-device infection was most common (51%), followed by sepsis (24%), external 
      pump component infection (20%) and internal pump component infection (5%). Most 
      infections were bacterial (73%) and required intravenous therapy only (77%). The 
      risk of infection in the constant phase was higher in patients with a history of 
      prior infection and in patients with a history of a non-infectious major AEs. 
      Survival was lower after infection only in CF patients (p = 0.008). CONCLUSIONS: 
      Infection was the most common AE after pediatric VAD implantation. Non-device 
      infections were most common. The best predictor of a future infection was a past 
      infection. CF patients have higher risk of death after an infection.
CI  - Copyright (c) 2018 International Society for Heart and Lung Transplantation. 
      Published by Elsevier Inc. All rights reserved.
FAU - Auerbach, Scott R
AU  - Auerbach SR
AD  - Division of Cardiology, Department of Pediatrics, University of Colorado Anschutz 
      Medical Campus and Children's Hospital Colorado, Aurora, Colorado, USA. 
      Electronic address: scott.auerbach@childrenscolorado.org.
FAU - Richmond, Marc E
AU  - Richmond ME
AD  - Division of Pediatric Cardiology, Columbia University, New York, New York, USA.
FAU - Schumacher, Kurt R
AU  - Schumacher KR
AD  - Division of Cardiology, Department of Pediatrics, University of Michigan, Ann 
      Arbor, Michigan, USA.
FAU - Lopez-Colon, Dalia
AU  - Lopez-Colon D
AD  - Department of Pediatrics, Congenital Heart Center, University of Florida, 
      Gainesville, Florida, USA.
FAU - Mitchell, Max B
AU  - Mitchell MB
AD  - Division of Pediatric Cardiothoracic Surgery, University of Colorado Anschutz 
      Medical Campus and Children's Hospital Colorado, Aurora, Colorado, USA.
FAU - Turrentine, Mark W
AU  - Turrentine MW
AD  - Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Indiana 
      University School of Medicine, Indianapolis, Indiana, USA.
FAU - Cantor, Ryan S
AU  - Cantor RS
AD  - Kirklin Institute for Research in Surgical Outcomes, University of Alabama at 
      Birmingham, Birmingham, Alabama, USA.
FAU - Niebler, Robert A
AU  - Niebler RA
AD  - Section of Critical Care, Department of Pediatrics, Medical College of Wisconsin, 
      Milwaukee, Wisconsin, USA.
FAU - Eghtesady, Pirooz
AU  - Eghtesady P
AD  - Section of Pediatric Cardiothoracic Surgery, Washington University School of 
      Medicine, St. Louis, Missouri, USA.
LA  - eng
GR  - HHSN268201100025C/HL/NHLBI NIH HHS/United States
PT  - Journal Article
DEP - 20171003
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
SB  - IM
CIN - J Heart Lung Transplant. 2018 Jan;37(1):139-140. PMID: 29169883
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Heart Failure/*surgery
MH  - Heart-Assist Devices/*adverse effects
MH  - Humans
MH  - Male
MH  - Prosthesis-Related Infections/*epidemiology/*etiology
MH  - Registries
MH  - United States
PMC - PMC5849428
MID - NIHMS917340
OTO - NOTNLM
OT  - adverse events
OT  - continuous-flow device
OT  - infection
OT  - pulsatile-flow device
OT  - ventricular assist device
EDAT- 2017/11/07 06:00
MHDA- 2019/11/28 06:00
PMCR- 2019/01/01
CRDT- 2017/11/07 06:00
PHST- 2017/05/21 00:00 [received]
PHST- 2017/07/16 00:00 [revised]
PHST- 2017/09/26 00:00 [accepted]
PHST- 2017/11/07 06:00 [pubmed]
PHST- 2019/11/28 06:00 [medline]
PHST- 2017/11/07 06:00 [entrez]
PHST- 2019/01/01 00:00 [pmc-release]
AID - S1053-2498(17)32028-4 [pii]
AID - 10.1016/j.healun.2017.09.013 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2018 Jan;37(1):46-53. doi: 10.1016/j.healun.2017.09.013. 
      Epub 2017 Oct 3.