Continuous‐flow left ventricular assist devices: Management in the emergency department

Hockstein, M.J.

doi:10.1002/emp2.12178

Cited by 5 publications

(5 citation statements)

References 35 publications

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“…O fabricante do Heart Mate® desaconselha as compressões torácicas por possibilidade de deslocamento da cânula de outflow, inserido no ventrículo esquerdo (Thoratec Corporation, 2018). Entretanto, American Heart Association (AHA) recomenda o início precoce da ressuscitação cardiopulmonar em pacientes com DAVLP quando não há perfusão adequada, com o rebaixamento do nível de consciência, entrar em contato imediatamente com o setor especializado e o coordenador dos DAVLP, para a continuidade do atendimento (Hockstein, 2020;Peberdy et al, 2017). Os dois estudos de Shinar (Shinar et al, 2014) e Garg (Garg et al, 2014), mesmo com resultados preliminares e uma população limitada, também sugerem que as compressões torácicas não são tão inseguras com relação ao deslocamento das cânulas do dispositivo, com a necessidade de detecção precoce da parada cardiopulmonar e o início do atendimento imediato, para um melhor desfecho.…”

Section: Discussionunclassified

Atendimento de emergência ao paciente com Dispositivo de Assistência Ventricular de Longa Permanência

Prado,

Saraiva,

Santos

et al. 2023

RSD

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Objetivo: Construir um fluxograma de atendimento de emergências cardiovasculares em pacientes portadores de Dispositivos de Assistência Ventricular de Longa Permanência. Metodologia: Estudo metodológico para elaboração do fluxograma de atendimento de emergências cardiovasculares aos pacientes em uso de Dispositivos de Assistência Ventricular de Longa Permanência baseado na revisão integrativa da literatura, nas bases e/ou portais Biblioteca Virtual em Saúde, Pubmed, Scopus, Cinahl e Web of Science, sem definição de tempo inicial até fevereiro de 2023. Resultado: Foram encontrados 3 artigos com maior evidência científica sobre a reanimação cardiopulmonar em pacientes com implante de Dispositivos de Assistência Ventricular de Longa Permanência, onde sugerem a segurança das compressões torácicas no atendimento de emergência cardiovascular desses pacientes. Para a construção do fluxograma foi utilizado os artigos de revisão da literatura, adequando para a realidade vivida nos hospitais brasileiros. Conclusão: O atendimento dos pacientes com dispositivo de assistência ventricular necessita de conhecimento e preparo da equipe multiprofissional para não atrasar a identificação e tomada de decisão. É necessário estudos maiores e com relevância metodológica mais robusta para garantir a eficácia da conduta do profissional, garantindo segurança para o paciente.

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Section: Discussionunclassified

Atendimento de emergência ao paciente com Dispositivo de Assistência Ventricular de Longa Permanência

Prado,

Saraiva,

Santos

et al. 2023

RSD

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“…In patients without an LVAD, MAP > 60 mmHg usually provides adequate tissue perfusion. For LVAD patients, it is recommended to maintain the MAP value ≤ 80 mmHg with hypotensive medication [10][11][12].…”

Section: Differences In Patient Examinationmentioning

confidence: 99%

Critical considerations in management of patients with left ventricular assist device in an Emergency Department practice

Kłosiewicz

Mazur²,

Zalewski³

et al. 2022

Medical Research Journal

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In recent years, mechanical circulatory support has become an increasingly used treatment strategy for end-stage heart failure. Due to technological progress and higher availability of this therapy, the number of patients receiving left ventricular assist devices (LVAD) is increasing. A natural consequence of this is occurrence of complications related to this therapy. A patient presenting to an emergency department (ED) expects the highest level of care.Emergency department staff should have basic knowledge and skills to provide initial diagnostic and therapeutic interventions for patients with LVAD in life-threatening conditions. The most common reasons for patients with LVADs presenting to the ED are bleeding, heart rhythm disorders, stroke, or infections. This article aims to present the basic information that may be useful during the first medical contact in an emergency department. The authors have discussed the issue of diagnosis, and differences in laboratory findings and indicate where to best seek help. The article is dedicated to physicians, nurses, and paramedics working in emergency departments.

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“…Continuous flow left ventricular assist devices (CF‐LVADs) are miniature pumps used to support failing left ventricle in end‐stage heart failure patients 1 . Although the complication rates in patients reduced with the improved design in third‐generation devices, adverse events with risk of morbidity and mortality still exist in the patients supported with CF‐LVAD 2,3 . Moreover, clinical conditions independent of pump support, such as anaemia, may result in undesired clinical outcomes in heart failure patients supported with CF‐LVAD 4 …”

Section: Introductionmentioning

confidence: 99%

“…CF-LVAD. 2,3 Moreover, clinical conditions independent of pump support, such as anaemia, may result in undesired clinical outcomes in heart failure patients supported with CF-LVAD. 4 Iron deficiency is the leading cause of anaemia, whereas chronic inflammation with haematologic diseases or different conditions may also cause anaemia.…”

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confidence: 99%

Computational evaluation of heart failure and continuous flow left ventricular assist device support in anaemia

Bozkurt

2023

Numer Methods Biomed Eng

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Anaemia is common in end‐stage heart failure patients supported with continuous flow left ventricular assist device (CF‐LVAD) and is associated with adverse outcomes such as heart failure readmission. This study evaluates the haemodynamic effects of anaemia on cardiac function and cerebral blood flow in heart failure patients supported with CF‐LVAD using computational simulations. A dynamic model simulating cardiac function, systemic, pulmonary and cerebral circulations, cerebral flow autoregulatory mechanisms and gas contents in blood was used to evaluate the effects of anaemia and iron deficiency in heart failure and during CF‐LVAD support. CF‐LVAD therapy was simulated by a model describing HeartMate 3. Anaemia and iron deficiency were simulated by reducing the haemoglobin level from 15 to 9 g/dL and modifying scaling coefficients in the models simulating heart chamber volumes. Reduced haemoglobin levels decreased the arterial O2 content, which increased cerebral blood flow rate by more than 50% in heart failure and during CF‐LVAD assistance. Reduced haemoglobin levels simulating anaemia had minimal effect on the arterial and atrial blood pressures and ventricular volumes. In contrast, iron deficiency increased end‐diastolic left and right ventricular diameters in heart failure from 6.6 cm to 7 cm and 2.9 cm to 3.1 cm and during CF‐LVAD support from 6.1 to 6.4 cm and 3.1 to 3.3 cm. The developed numerical model simulates the effects of anaemia in failing heart and during CF‐LVAD therapy. It is in good agreement with clinical data and can be utilised to assess CF‐LVAD therapy.

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Continuous‐flow left ventricular assist devices: Management in the emergency department

Cited by 5 publications

References 35 publications

Atendimento de emergência ao paciente com Dispositivo de Assistência Ventricular de Longa Permanência

Atendimento de emergência ao paciente com Dispositivo de Assistência Ventricular de Longa Permanência

Critical considerations in management of patients with left ventricular assist device in an Emergency Department practice

Computational evaluation of heart failure and continuous flow left ventricular assist device support in anaemia

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