Division of Cardiology, Salvatore Maugeri Foundation, IRCCS, Veruno, NO, Italy.
Int J Cardiol. 2013 Oct 15;168(6):5143-8. doi: 10.1016/j.ijcard.2013.08.003. Epub 2013 Aug 14.
Ventricular assist device (VAD) technology has rapidly evolved, and VADs are now seen as a reliable lifesaving option to support the failing heart in the short- and long-term: in some cases, VAD therapy represents a well-accepted treatment option for advanced heart failure that can obviate the need for heart transplantation. In the near future, more and more cardiologists will encounter VAD patients in their clinical practice and need to know how to handle the inherent risks associated with VAD use. The emergency care of a VAD patient differs from that of conventional practice and specific expertise is required to avoid inappropriate management that could lead to inefficient treatment and/or dangerous consequences. Here, we describe two emergency scenarios in VAD patients, two paradigmatic clinical in-hospital situations, in different settings. Following a brief overview of the role of cardiopulmonary resuscitation maneuvers in VAD patients, we propose a working algorithm that might help to ensure a timely and efficient response to acute demands in this setting.
心室辅助装置（VAD）技术迅速发展，VAD 现在被视为一种可靠的救生选择，可以在短期和长期内支持衰竭的心脏：在某些情况下，VAD 治疗代表了一种可接受的晚期心力衰竭治疗选择，可以避免心脏移植的需要。在不久的将来，越来越多的心脏病专家将在他们的临床实践中遇到 VAD 患者，并且需要知道如何处理与 VAD 使用相关的固有风险。VAD 患者的急救护理与常规实践不同，需要特定的专业知识来避免可能导致治疗效率低下和/或危险后果的不当管理。在这里，我们描述了 VAD 患者的两种紧急情况，这是两种不同情况下的典型临床住院情况。简要概述了心肺复苏术在 VAD 患者中的作用后，我们提出了一个工作算法，以帮助确保在这种情况下对急性需求做出及时有效的反应。
