The burden of innovation in the pediatric heart center

PURPOSE OF REVIEW: The purpose of this review is to elucidate the growing complexity involved in providing pediatric cardiac care in the contemporary era of innovation. Aiming to highlight the phenomenon of chronic critical illness in a pediatric heart center, this review outlines the burdens placed on those caring for these uniquely challenging patients and poses considerations for alleviating those burdens. RECENT FINDINGS: As care advancements drive improved survival for children with heart disease, heart centers face a growing population of chronically critically ill patients with high resource utilization and uncertain trajectories. Preterm infants, single ventricles, and complex heart failure patients require significant interventions and expertise. Their lengthy courses challenge care delivery systems and resources, in addition to placing significant emotional and cognitive burdens on the multidisciplinary teams. SUMMARY: The growing population of chronically critically ill cardiac patients are some of the most challenging both at the system level and on the team members. While undertaking innovative therapies, we must recognize that survival as an outcome cannot be separated from associated costs of achieving that outcome; the resultant burdens of innovation cannot be ignored. Heart centers must take a proactive stance in optimizing care for children with prolonged illness while also addressing the needs of those who care for them.