Long Term Mechanical Circulatory Support Devices

temporarily, 5-10 days, decompensates, hemodynamic, function, workload

short term devices are used _____ (_____) when patient _____ and cannot maintain _____ responses, work to improve _____ and decrease _____

afterload, myocardial perfusion, diastole, systole, expands, suction, every cycle, strength, precautions

IABP functions to decrease _____ and increase _____, inflates during _____ and deflates during _____, _____ aorta and creates _____ effect, 1:1 ratio = assist _____ vs decreasing ratio = improving heart _____, placed through femoral or axillary a = _____

pull up

impella uses pump to _____ blood

heart, lung failure, external lung, oxygenation, mechanical ventilation, respiratory

VA ECMO = _____/_____, functions as _____ for _____, patient also on _____, VV = _____ only

improve, waiting, transplant

long term circulatory support used with individuals who do NOT _____ or _____ for _____

left

_____ ventricular assist device is most common

heart failure, unresponsive, medical, cardiogenic shock

VAD candidates include advanced _____ that is _____ to full _____ therapies OR _____

bridge to decision, bridge to candidacy, bridge to transplant, destination therapy

VAD goals (4)

mechanically assisted, perfused, cardiac rehab

when heart is _____ = body _____ = _____ possible

final, transplant candidate

VAD is used as destination therapy as _____ device, person is NOT a _____

pump, drive line, controller, power source

VAD components (4)

nonpulsatile, centrifuge, all, SBP/DBP, MAP, peripheral pulse, RPE

most VAD pumps are _____ (_____ = active assist at _____ times), NO defined _____ so must measure _____ and _____ may NOT be palpable so must rely on _____

native, contracting, preload, venous blood, adapts, stroke volume, afterload, periphery

with VAD _____ heart is still _____, _____ sensitivity = _____ still returning and VAD _____ as needed to augment _____, _____ sensitivity = pumps to _____

sternal precautions, insertion, infection, abdominal motion

after VAD implantation observe _____, inspect driveline _____ area for _____, caution with _____

doppler, 70-90

MAP is measured with _____, should be between _____ mmHg

flow, VAD, cardiac output, pulsatile index, ventricle

monitor VAD _____ (_____ contribution to total _____) and _____ (_____ contribution to pump)

<2.5, 1-10, output, failure

low flow alarm = _____ L/min, PI range = _____, low values = low _____ = increasing _____

medications, beta blockers, ACE inhibitors

patients with VAD likely on _____ to further reduce cardiac workload = _____ or _____

device failure, major surgery, comorbidities, infection, arrhythmia, respiratory, renal, neurologic

VAD complications include _____ and anything occurring with _____ due to _____ (severe _____ or bleeding, cardiac _____, _____ failure, ______ or _____ dysfunction)

suck down, contact, VAD, ventricular cavity, septum, drop, output, supine

_____ event occurs when _____ between _____ and _____/_____ occurs, rapid _____ in VAD _____, place patient in _____ and call for immediate assistance

rehabilitation, peripheral, PLOF, progression, similar, transplant

evidence supports _____ with VAD, patient can improve through _____ mechanisms limited by _____, many variables that impact _____, _____ outcomes to _____ patients

bridge to transplant, imminent death, biventricular failure, destination

total artificial heart candidates are those approved as _____ for those at risk for _____ due to _____, NOT currently _____

replaces, ventricles, valves

total artificial heart _____ both _____ and all _____

mobility, rotary, trauma

newer total artificial heart models are smaller for increased _____, future models use electromechanical _____ pump for less _____ to blood

training, sternal precautions, insertion, abdominal motion, gait belt

total artificial heart rehabilitation requires specialized _____, _____ in place, inspect driveline _____, caution with _____, _____ might not be appropriate

rate, flow, volume, orthostasis, RPE, spo2, VAD, hypotension, modify, stop, blunted blood pressure

with total artificial heart monitor device _____, _____/_____, symptoms of _____, exercise tolerance with _____ and _____, activity guidelines modeled after _____ and adjusted as needed, monitor for episodes of _____, _____/_____ activity with SOB, RPE >13, SBP <80/>20 decrease, flow <3, neurologic changes, bleeding at insertion, _____ response reported