日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Background: The number of medical consultations for severe heart failure in pediatric patients has been increasing in all regions in Japan. As a result, high-risk interhospital transport is becoming a more challenging task.

Methods: Forty-two pediatric patients with severe heart failure who were transferred to our hospital between July 2010 and December 2018 were reviewed. We investigated patient characteristics, type of transport, and outcomes after transportation, including implantation of a ventricular assist device. We also discuss practical issues of interhospital transportation in Japan.

Results: The underlying cardiac diseases were dilated cardiomyopathy in 25 patients, restrictive cardiomyopathy in 12 patients, and acute myocarditis in 5 patients. Twenty-six patients were transferred by land and 16 patients by air. The continuation of intensive care was mandatory especially in 22 cases (52.3％) with ventilator and 14 (33.3％) with PCPS. More than 80％ of cases required VAD implantation after interhospital transport. In addition, 8 cases who needed treatment intensification after transportation tend to be younger. Ten patients underwent heart transplantation, whereas 11 cases were deceased. It is also important to consider appropriate blood access and to provide sufficient information to family members.

Conclusion: Early interhospital collaboration and transport planning based on a patient’s condition are essential for the treatment of severe heart failure in pediatric patients. Interhospital transportation should be supported by a medical team with special experience. To improve the prognosis of severe heart failure in children, we need to consider further improvement in the management of interhospital medical transport.