Stage-specific integrated nursing management enables successful transition to left ventricular assist device support in end-stage dilated cardiomyopathy: a case report

Introduction Patients with end-stage heart failure complicated by cardiogenic shock and multiple organ dysfunction often require sequential mechanical circulatory support. However, evidence regarding integrated nursing management during transitions between multiple life-support modalities remains limited. This case report describes the nursing management of a patient with end-stage dilated cardiomyopathy who successfully transitioned from acute rescue therapy to long-term mechanical circulatory support. Case presentation A 39-year-old female with end-stage dilated cardiomyopathy complicated by cardiogenic shock and subsequent cardiac arrest underwent sequential life support interventions, including an intra-aortic balloon pump, extracorporeal membrane oxygenation, continuous renal replacement therapy, and ultimately, left ventricular assist device implantation. A dynamic, phase-based integrated nursing management strategy was implemented across four distinct clinical stages, focusing on precise hemodynamic perfusion monitoring, coordinated fluid and electrolyte balance during combined extracorporeal therapies, perioperative infection prevention, and early multi-dimensional physical and psychological rehabilitation. Following this individualized, multidisciplinary nursing approach, the patient's hemodynamic status stabilized, renal and respiratory functions recovered, and she was successfully discharged with favorable functional independence. Conclusion Stage-specific integrated nursing management represents a vital conceptual advance in critical care, serving as a central coordinating mechanism that optimizes treatment continuity, enhances organ recovery, and ensures a safe transition to long-term survival in patients facing refractory circulatory failure.