Is a palpable pulse always restored during cardiopulmonary resuscitation in a patient with a left ventricular assist device?

Nicholas A. Haglund, Kelly Schlendorf, Mary Keebler, Charu Gupta, Simon Maltais, E. Wesley Ely, Daniel Lenihan

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

End-stage heart failure patients are being supported with continuous flow left ventricular assist devices (CF-LVAD) in increasing numbers. The severe physiologic and pharmacologic derangements associated with end-stage heart failure therapies predispose these patients to delirium. During a delirious episode, a patient may inadvertently disconnect CF-LVAD equipment, which may have dangerous consequences. Unfortunately, it is not yet routine to use readily available clinical monitoring tools to allow early detection of delirium in this high-risk population. The authors present a case of acute hyperactive delirium leading to pump power disconnection and cardiopulmonary arrest occurring 7 days after CF-LVAD implantation. The case highlights the need for delirium awareness in the cardiovascular intensive care unit and the unique challenges associated with resuscitation of CF-LVAD patients. The authors propose that cardiovascular intensive care unit patients undergo at least twice daily delirium monitoring and provide a novel resuscitation algorithm for patients who have CF-LVADs.

Original languageEnglish (US)
Pages (from-to)322-327
Number of pages6
JournalAmerican Journal of the Medical Sciences
Volume347
Issue number4
DOIs
StatePublished - Apr 2014

Keywords

  • Code algorithm
  • Delirium
  • Heart failure
  • Left ventricular assist device

ASJC Scopus subject areas

  • Medicine(all)

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