Detailed contribution information
| Contribution title | 3121 - Nurturing Bodies Hearts and Minds in Cardiac Transplant: An Ever Changing Picture |
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| Contribution code | PS02-63 (P) |
| Authors | |
| Form of presentation | Poster |
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| Abstract |
Objectives: According to the registry of the International Society for Heart and Lung Transplan-tation, in 2012, 512 heart transplants were performed in children worldwide. Cardiac transplant is a therapeutic alternative for end stage heart disease that can be the result of 1) errors in the formation of the heart, (2) cardiac tumors, (3) infections, and (4) toxins that damage the myocardium. Depending on duration, some of these physiological states place children at risk for delayed motor and cognitive development. Prior to transplant, behavioral and psychological distress can rise as there are multiple transitional periods. Serrano Ikkos (1997) reported that 25% of pediatric patients met criteria for a psychiatric disorder and 60% demonstrated impairment in psychosocial functioning while awaiting a heart or heart-lung transplant . DeMaso (2004) found that 25% of patients and families had lasting psychological symptoms and emotional adjustment difficulties post-transplant. There is an evolving literature in providing psychological supports to patients and families undergoing cardiac transplant but limited to no literature on pharmacological interventions and their effects. Methods: A review of the literature will be presented regarding existing reports of psychotropic use in cardiac transplant patients and recommendations on monitoring. Using a case example, we will review the indications for psychotropic use and management of side effects and present the pattern of medication use at our institution for a cohort of cardiac transplant patients. In this cohort, we will look specifically at the indications for use, occurrence of side effects, and items monitored before and during use of the medication. Results: Psychotropic medication was able to be utilized to treat anxiety, depression, and delirium in children awaiting heart transplant and post-transplantation. Side effects that occurred in the sample included QTc prolongation, sedation, and restless leg syndrome. Conclusions: Psychopathology in children undergoing and surviving cardiac transplantation exists and can be treated pharmacologically while being mindful of drug interactions, pharmacokinetics, and the dynamic clinical picture. |