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 language | English (US) |
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Pages (from-to) | 322-327 |
Number of pages | 6 |
Journal | American Journal of the Medical Sciences |
Volume | 347 |
Issue number | 4 |
DOIs | |
State | Published - Apr 2014 |
Keywords
- Code algorithm
- Delirium
- Heart failure
- Left ventricular assist device
ASJC Scopus subject areas
- General Medicine