Background and Aims The number of children being hospitalized for heart failure (HF) is increasing and, in recent years, mechanical circulatory support (MCS) is gaining more importance in the treatment end stage HF. The use of these complex technology implies changes in nursing assistance with equally complex aspects of care. The aim of this work was to describe our experience in the management of pediatric patients supported by different devises at the cardiology department at the Bambino Gesù Children’s Hospital.

Methods Within the last 5 years, the MCS have been used in children with severe circulatory failure resistant to pharmacological therapy. ECMO was used in 83 pediatric patients (aged3.4±6.0years),Ventricular assist devices in 27, Berlin Heart EXCOR Pediatric was implanted in 23 children (aged5.5±6.8years), Heart Mate II in two children (13 ages), and Jarvik 2000 in 3 adolescents. These were patients with cardiomyopathy, fulminant myocarditis, end-stage congenital cardiac defects, and acute heart failure after congenital heart surgery.

Results Nursing intensive care management is very complex and includes infection and anticoagulation monitoring, wound care: surgical site and cannulas/pedestal medication, nutritional support, pain management, psychological support, mobilization and the daily nursing management of the children.

Conclusions Our experience shows that management of pediatric patients on MCS requires a highly specialized pediatric team. The goal of a nurse caring for a child on MCS is to be an active participant of all aspects of the patient’s care including a deep understanding of the patient’s physiology, of the indication for mechanical support, and of the most important complication that can occur.