Skip to main content
Journal cover image

Clinical pharmacology considerations for children supported with ventricular assist devices.

Publication ,  Journal Article
Sherwin, J; Thompson, E; Hill, KD; Watt, K; Lodge, AJ; Gonzalez, D; Hornik, CP
Published in: Cardiol Young
September 2018

The ventricular assist device is being increasingly used as a "bridge-to-transplant" option in children with heart failure who have failed medical management. Care for this medically complex population must be optimised, including through concomitant pharmacotherapy. Pharmacokinetic/pharmacodynamic alterations affecting pharmacotherapy are increasingly discovered in children supported with extracorporeal membrane oxygenation, another form of mechanical circulatory support. Similarities between extracorporeal membrane oxygenation and ventricular assist devices support the hypothesis that similar alterations may exist in ventricular assist device-supported patients. We conducted a literature review to assess the current data available on pharmacokinetics/pharmacodynamics in children with ventricular assist devices. We found two adult and no paediatric pharmacokinetic/pharmacodynamic studies in ventricular assist device-supported patients. While mechanisms may be partially extrapolated from children supported with extracorporeal membrane oxygenation, dedicated investigation of the paediatric ventricular assist device population is crucial given the inherent differences between the two forms of mechanical circulatory support, and pathophysiology that is unique to these patients. Commonly used drugs such as anticoagulants and antibiotics have narrow therapeutic windows with devastating consequences if under-dosed or over-dosed. Clinical studies are urgently needed to improve outcomes and maximise the potential of ventricular assist devices in this vulnerable population.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Cardiol Young

DOI

EISSN

1467-1107

Publication Date

September 2018

Volume

28

Issue

9

Start / End Page

1082 / 1090

Location

England

Related Subject Headings

  • Thromboembolism
  • Prosthesis-Related Infections
  • Humans
  • Heart-Assist Devices
  • Heart Failure
  • Child
  • Cardiovascular System & Hematology
  • Anticoagulants
  • Anti-Infective Agents
  • 3201 Cardiovascular medicine and haematology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Sherwin, J., Thompson, E., Hill, K. D., Watt, K., Lodge, A. J., Gonzalez, D., & Hornik, C. P. (2018). Clinical pharmacology considerations for children supported with ventricular assist devices. Cardiol Young, 28(9), 1082–1090. https://doi.org/10.1017/S1047951118001075
Sherwin, Jennifer, Elizabeth Thompson, Kevin D. Hill, Kevin Watt, Andrew J. Lodge, Daniel Gonzalez, and Christoph P. Hornik. “Clinical pharmacology considerations for children supported with ventricular assist devices.Cardiol Young 28, no. 9 (September 2018): 1082–90. https://doi.org/10.1017/S1047951118001075.
Sherwin J, Thompson E, Hill KD, Watt K, Lodge AJ, Gonzalez D, et al. Clinical pharmacology considerations for children supported with ventricular assist devices. Cardiol Young. 2018 Sep;28(9):1082–90.
Sherwin, Jennifer, et al. “Clinical pharmacology considerations for children supported with ventricular assist devices.Cardiol Young, vol. 28, no. 9, Sept. 2018, pp. 1082–90. Pubmed, doi:10.1017/S1047951118001075.
Sherwin J, Thompson E, Hill KD, Watt K, Lodge AJ, Gonzalez D, Hornik CP. Clinical pharmacology considerations for children supported with ventricular assist devices. Cardiol Young. 2018 Sep;28(9):1082–1090.
Journal cover image

Published In

Cardiol Young

DOI

EISSN

1467-1107

Publication Date

September 2018

Volume

28

Issue

9

Start / End Page

1082 / 1090

Location

England

Related Subject Headings

  • Thromboembolism
  • Prosthesis-Related Infections
  • Humans
  • Heart-Assist Devices
  • Heart Failure
  • Child
  • Cardiovascular System & Hematology
  • Anticoagulants
  • Anti-Infective Agents
  • 3201 Cardiovascular medicine and haematology