(1140) Steroids Reduce Vad-Related Inflammation in Children

PurposeThe role of methylprednisolone (MP) in reducing inflammation related to new ventricular assist device (VAD) implantation and the association MP use with pediatric VAD outcomes are uncertain.MethodsWe performed a single center retrospective cohort study children <21 yrs old placed on durable support from 12/2019 12/2021. Medical records were reviewed for duration, serial measures laboratory markers hemolysis (lactate dehydrogenase (LDH), plasma free hemoglobin (plasma Hb), C-reactive protein (CRP), fibrinogen), (stroke, pump exchange, infection - per Pedimacs criteria).ResultsThirty two patients (53% male, median age 7 yrs, 14 pulsatile flow, 18 continuous flow) included. Etiology heart failure was cardiomyopathy 60%, ventricle congenital disease (CHD) 27%, biventricular CHD 13%. Nineteen (59%) received ≥1 course (1mg/kg/dose twice day) during support, started at 8 days post-implant (IQR 11 days), 4 3 5 days). Post-MP, there significant reduction CRP (median 14.1 mg/dL down 4.1 mg/dL, p = 0.001) fibrinogen 609 344 p<0.001) but no change LDH (p 0.184) or Hb 0.858), compared pre-MP. Patients who tended have higher daily rate rise first after implant, decline 2nd 3rd weeks implant (Table, p>0.1). On univariate analysis, be associated stroke 0.064) 0.093). A greater proportion underwent exchange (26% vs 8%, 0.361).ConclusionMP used over half effective inflammatory towards normal. may complications infection, potentially reflecting pattern sicker patients. Larger studies needed define impact complications. The uncertain. We criteria). Thirty 0.361).