Emergency patient care with a Long Stay Ventricular Assist Device

Authors

DOI:

https://doi.org/10.33448/rsd-v12i8.42995

Keywords:

Heart-Assist Devices; Cardiac Assistance Devices; Cardiopulmonary resuscitation.

Abstract

Objective: To construct a flowchart for the emergency treatment of cardiovascular events in patients with Left Ventricular Assistance Devices. Methodology: A methodological study was carried out to develop the flowchart for emergency cardiovascular treatment in patients using Ventricular Assistance Devices based on an integrative review of the literature from the Virtual Health Library, PubMed, Scopus, Cinahl, and Web of Science, without a defined time frame until February 2023. Result: Three articles with the highest scientific evidence on cardiopulmonary resuscitation in patients with Left Ventricular Assistance Devices implants were found, suggesting the safety of chest compressions in emergency cardiovascular treatment of these patients. The flowchart was constructed using the literature review articles, adapted to the reality of Brazilian hospitals. Conclusion: The treatment of patients with ventricular assistance devices requires knowledge and preparation from the multidisciplinary team to avoid delaying the identification and decision-making process. Further studies with stronger methodological relevance are necessary to ensure the effectiveness of professional conduct and to ensure the safety of the patient.

References

Aissaoui, N., Jouan, J., Gourjault, M., Diebold, B., Ortuno, S., Hamdan, A., Latremouille, C., Pirracchio, R., & Morshuis, M. (2018). Understanding left ventricular assist devices. Blood Purification, 46(4), 292–300. https://doi.org/10.1159/000491872

Ayub-Ferreira, S., Souza Neto, J., Almeida, D., Biselli, B., Avila, M., Colafranceschi, A., Stefanello, B., Carvalho, B., Polanczyk, C., Galantini, D., Bocchi, E., Chamlian, E., Hojaij, E., Gaiotto, F., Pinton, F., Jatene, F., Ramires, F., Atik, F., Figueira, F., & Issa, V. (2016). Diretriz de assistência circulatória mecânica da sociedade brasileira de cardiologia. Arquivos Brasileiros de Cardiologia, 107(2). https://doi.org/10.5935/abc.20160128

Barssoum, K., Patel, H., Rai, D., Kumar, A., Hassib, M., Othman, H. F., Thakkar, S., El Karyoni, A., Idemudia, O., Ibrahim, F., Salem, T., Shariff, M., Jabri, A., ElBadawi, A., Khodjaev, S., Bandyopadhyay, D., Aronow, W. S., Parikh, V., Rao, M., & Soon, P. (2021). Outcomes of Cardiac Arrest and Cardiopulmonary Resuscitation in Patients With Left Ventricular Assist Device; an Insight From a National Inpatient Sample. Heart Lung and Circulation, 246–254. https://doi.org/10.1016/j.hlc.2021.05.096

Bowles, C. T., Hards, R., Wrightson, N., Lincoln, P., Kore, S., Marley, L., Dalzell, J. R., Raj, B., Baker, T. A., Goodwin, D., Carroll, P., Pateman, J., Black, J. J. M., Kattenhorn, P., Faulkner, M., Parameshwar, J., Butcher, C., Mason, M., Rosenberg, A., & Pitcher, D. W. (2017). Algorithms to guide ambulance clinicians in the management of emergencies in patients with implanted rotary left ventricular assist devices. Emergency Medicine Journal, 34(12), 842–849. https://doi.org/10.1136/emermed-2016-206172

Bui, A. L., Horwich, T. B., & Fonarow, G. C. (2011). Epidemiology and risk profile of heart failure. Nature Reviews Cardiology, 8(1), 30–41. https://doi.org/10.1038/nrcardio.2010.165

Busch, M. C., Haap, M., Kristen, A., & Haas, C. S. (2011). Asymptomatic sustained ventricular fibrillation in a patient with left ventricular assist device. Annals of Emergency Medicine, 57(1), 25–28. https://doi.org/10.1016/j.annemergmed.2010.05.023

Darling, C. E., Martindale, J. L., Hiestand, B. C., Bonnell, M., Colvin, M., DeFilippis, E. M., Elliott, T., Hamad, E., Pinney, S. P., Shah, K. B., Vierecke, J., & Givertz, M. M. (2020). An Emergency Medicine–focused Summary of the HFSA/SAEM/ISHLT Clinical Consensus Document on the Emergency Management of Patients With Ventricular Assist Devices. Academic Emergency Medicine, 27(7), 618–629. https://doi.org/10.1111/acem.13964

Eyituoyo, H. O., Aben, R. N., Arinze, N. C., Vu, D. P., & James, E. A. (2020). Ventricular fibrillation 7 years after left ventricular assist device implantation. American Journal of Case Reports, 21, 1–5. https://doi.org/10.12659/AJCR.923711

Fitzgibbon, J., Kman, N. E., & Gorgas, D. (2016). Asymptomatic Sustained Polymorphic Ventricular Tachycardia in a Patient with a Left Ventricular Assist Device: Case Report and what the Emergency Physician Should Know. Journal of Emergency Medicine, 50(3), e135–e141. https://doi.org/10.1016/j.jemermed.2015.11.038

Fugate, J. E., Brinjikji, W., Mandrekar, J. N., Cloft, H. J., White, R. D., Wijdicks, E. F. M., & Rabinstein, A. A. (2012). Post-cardiac arrest mortality is declining: A study of the US national inpatient sample 2001 to 2009. Circulation, 126(5), 546–550. https://doi.org/10.1161/CIRCULATIONAHA.111.088807

Garg, S., Ayers, C. R., Fitzsimmons, C., Meyer, D., Peltz, M., Bethea, B., Cornwell, W., Araj, F., Thibodeau, J., & Drazner, M. H. (2014). In-hospital cardiopulmonary arrests in patients with left ventricular assist devices. Journal of Cardiac Failure, 20(12), 899–904. https://doi.org/10.1016/j.cardfail.2014.10.007

Givertz, M. M., DeFilippis, E. M., Colvin, M., Darling, C. E., Elliott, T., Hamad, E., Hiestand, B. C., Martindale, J. L., Pinney, S. P., Shah, K. B., Vierecke, J., & Bonnell, M. (2019). HFSA/SAEM/ISHLT Clinical Expert Consensus Document on the Emergency Management of Patients with Ventricular Assist Devices. Journal of Cardiac Failure, 25(7), 494–515. https://doi.org/10.1016/j.cardfail.2019.01.012

Hockstein, M. A. (2020). Continuous‐flow left ventricular assist devices: Management in the emergency department. Journal of the American College of Emergency Physicians Open, 1(4), 362–370. https://doi.org/10.1002/emp2.12178

Kubrusly, L. F. (2019). Ventricular assist devices: An evolving field. Brazilian Journal of Cardiovascular Surgery, 34(1), III–V. https://doi.org/10.21470/1678-9741-2019-0043

Machado, C., & Silva, M. (2012). Possibilidades e Limites do Ciclo de Melhoria Contínua - PDSA (ou PDCA) como elemento de aprendizageM. Revista Metropolitana de Sustentabilidade, 2, 1–16.

Mangini, S., Alves, B. R., Silvestre, O. M., Pires, P. V. ieir., Pires, L. J. os. T., Curiati, M. N. ovae. C., & Bacal, F. (2015). Heart transplantation: review. In Einstein (São Paulo, Brazil) (Vol. 13, Issue 2, pp. 310–318). Instituto Israelita de Ensino e Pesquisa Albert Einstein. https://doi.org/10.1590/S1679-45082015RW3154

OCEBM. (2011). The Oxford Levels of Evidence 2.

Pal, J. D., Cleveland, J., Reece, B. T., Byrd, J., Pierce, C. N., Brieke, A., & Cornwell, W. K. (2020). Cardiac Emergencies in Patients with Left Ventricular Assist Devices. Heart Failure Clinics, 16(3), 295–303. https://doi.org/10.1016/j.hfc.2020.02.003

Patel, P., Williams, J. G., & Brice, J. H. (2011). Sustained ventricular fibrillation in an alert patient: Preserved hemodynamics with a left ventricular assist device. Prehospital Emergency Care, 15(4), 533–536. https://doi.org/10.3109/10903127.2011.598616

Peberdy, M. A., Gluck, J. A., Ornato, J. P., Bermudez, C. A., Griffin, R. E., Kasirajan, V., Kerber, R. E., Lewis, E. F., Link, M. S., Miller, C., Teuteberg, J. J., Thiagarajan, R., Weiss, R. M., & O’Neil, B. (2017). Cardiopulmonary Resuscitation in Adults and Children with Mechanical Circulatory Support: A Scientific Statement from the American Heart Association. Circulation, 135(24), e1115–e1134. https://doi.org/10.1161/CIR.0000000000000504

Perim, D., Mazer-Amirshahi, M., Trvalik, A., & Pourmand, A. (2019). Approach to Complications of Ventricular Assist Devices: A Clinical Review for the Emergency Provider. Journal of Emergency Medicine, 56(6), 611–623. https://doi.org/10.1016/j.jemermed.2019.03.012

Pistono, M., Corrà, U., Gnemmi, M., Imparato, A., Temporelli, P. L., Tarro Genta, F., & Giannuzzi, P. (2013). How to face emergencies in heart failure patients with ventricular assist device. International Journal of Cardiology, 168(6), 5143–5148. https://doi.org/10.1016/j.ijcard.2013.08.003

Robertson, J., Long, B., & Koyfman, A. (2016). The emergency management of ventricular assist devices. American Journal of Emergency Medicine, 34(7), 1294–1301. https://doi.org/10.1016/j.ajem.2016.04.033

Rohde, L. E. P., Montera, M. W., Bocchi, E. A., Clausell, N. O., de Albuquerque, D. C., Rassi, S., Colafranceschi, A. S., de Freitas Junior, A. F., Ferraz, A. S., Biolo, A., Barretto, A. C. P., Ribeiro, A. L. P., Polanczyk, C. A., Gualandro, D. M., Almeida, D. R., da Silva, E. R. R., Figueiredo, E. L., Mesquita, E. T., Marcondes-Braga, F. G., & Martins, W. de A. (2018). Diretriz brasileira de insuficiência cardíaca crônica e aguda. Arquivos Brasileiros de Cardiologia, 111(3), 436–539. https://doi.org/10.5935/abc.20180190

Santos, C. M. D. C., Pimenta, C. A. D. M., & Nobre, M. R. C. (2007). A estratégia PICO para a construção da pergunta de pesquisa e busca de evidências. Revista Latino-Americana de Enfermagem, 15(3), 508–511. https://doi.org/10.1590/S0104-11692007000300023

Shinar, Z., Bellezzo, J., Stahovich, M., Cheskes, S., Chillcott, S., & Dembitsky, W. (2014). Chest compressions may be safe in arresting patients with left ventricular assist devices (LVADs). Resuscitation, 85(5), 702–704. https://doi.org/10.1016/j.resuscitation.2014.01.003

Souza, M. T. de, Silva, M. D. da, & Carvalho, R. de. (2010). Integrative review: what is it? How to do it? Einstein (São Paulo), 8(1), 102–106. https://doi.org/10.1590/s1679-45082010rw1134

Thoratec Corporation (Ed.). (2018). Heart Mate III Left Ventricular Assist System Instruction for Use.

Vierecke, J., Schweiger, M., Feldman, D., Potapov, E., Kaufmann, F., Germinario, L., Hetzer, R., Falk, V., & Krabatsch, T. (2017). Emergency procedures for patients with a continuous flow left ventricular assist device. Emergency Medicine Journal, 34(12), 831–841. https://doi.org/10.1136/emermed-2015-204912

Published

29/08/2023

How to Cite

PRADO, B. S. .; SARAIVA, E. L. .; SANTOS, I. G. M. dos .; BALESTRA, N.; BISELLI, B.; CASTELLI, A. A.; SOUSA, C. S. . Emergency patient care with a Long Stay Ventricular Assist Device . Research, Society and Development, [S. l.], v. 12, n. 8, p. e16012842995, 2023. DOI: 10.33448/rsd-v12i8.42995. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/42995. Acesso em: 16 may. 2024.

Issue

Section

Health Sciences