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cardiac assist device; ventricular assist device
Special laboratory:
- echocardiography to evaluate ventricular assist device performance
Management:
- cardiopulmonary resuscitation (CPR)
- most current mechanical support devices are continuous-flow; thus, a palpable pulse will be absent
- blood pressure (BP) measurement can be difficult
- automated BP cuffs accurately assess BP in ~50%
- a manual sphygmomanometer & a Doppler ultrasound probe may be useful
- most common causes of ventricular assist device pump failure
- disconnection of the power
- check the power suppy & connections
- transport patients with their backup power supplies because receiving hospitals may lack that equipment
- failure of the driveline
- CPR for mean arterial pressure <= 50 mm Hg*
- patients in ventricular tachycardia or ventricular fibrillation may still have adequate perfusion & be conscious
- these patients should not receive CPR
* mean arterial pressure >= 50 mm Hg may be needed to maintain consciousness
Specific
left ventricular assist device (LVAD)
right heart pump (Impella RP System)
General
device (medical device)
References
- Peberdy MA et al.
Cardiopulmonary resuscitation in adults and children with
mechanical circulatory support: A Scientific Statement from the
American Heart Association.
Circulation 2017 Jun 13; 135:e1115
PMID: 28533303