Gamified Cardiopulmonary Rehabilitation in a Child Undergoing LVAD Bridging Therapy to Heart Transplantation: A Case Report

Vollständiger Abstract

Worum geht es in dieser Arbeit?

ABSTRACT This report details the comprehensive, gamified cardiopulmonary rehabilitation of a 6‐year‐old girl undergoing a complex clinical journey from left ventricular assist device (LVAD) bridge therapy to successful heart transplantation. Given the paucity of standardised protocols for this high‐risk population, a structured, multidisciplinary team (MDT)‐guided pathway was implemented, adapting interventions to the distinct phases of LVAD support and post‐transplant recovery. Key nursing and rehabilitation strategies included initiating very early mobilisation in the cardiac intensive care unit (CICU) with meticulous safety precautions for the LVAD driveline and post‐sternotomy incision, implementing a tiered programme of play‐based respiratory training games to improve pulmonary function, and guiding the patient through a progressive, gamified exercise regimen encompassing low‐intensity aerobic games and combined resistance‐aerobic training. Throughout, continuous risk monitoring and dynamic adjustment based on haemodynamic and device‐specific parameters were paramount. This individualised, phased approach effectively improved the patient's cardiopulmonary function, muscle strength and exercise tolerance. She was discharged on postoperative Day 44 with a left ventricular ejection fraction of 69%, NYHA Class I cardiac function, grade 5 muscle strength and a 6‐min walk distance of 260 m, without rehabilitation‐related adverse events. This case demonstrates a feasible and effective model for rehabilitating paediatric patients across the challenging continuum from mechanical circulatory support to heart transplantation. This case provides a structured, reproducible framework for cardiopulmonary rehabilitation in paediatric patients transitioning from LVAD support to heart transplantation. It emphasises the necessity of phase‐adapted interventions, rigorous safety monitoring and the integration of gamification to enhance engagement and outcomes, offering practical guidance for nurses and therapists in this specialised field.