Section of Cardiac Surgery, Department of Surgery, University of Chicago Medical Center, Chicago, IL, USA.
Int J Artif Organs. 2021 Feb;44(2):110-114. doi: 10.1177/0391398820944931. Epub 2020 Aug 11.
Tobacco smoking is a significant source of morbidity in patients with a durable left ventricular assist device. While various cessation strategies have been investigated, the ability of ventricular assist device centers to implement a successful tobacco cessation program remains uncertain. We explored various cessation strategies employed by ventricular assist device centers and assessed perspectives of their effectiveness, as well as institutional investment in these programs.
A 37-question online self-report survey was created using Survey Monkey and distributed worldwide. We investigated (1) programmatic strategies utilized for smoking cessation, (2) the respondent's perspective on the effectiveness of these strategies, (3) the structure with which these therapies are administered, and (4) overall organizational support for these treatments.
A total of 47 centers worldwide completed the survey. The most common methods of tobacco cessation were pharmacologic and nicotine replacement therapy (78% and 66%). However, only about half (47% and 50%, respectively) of the centers indicated that these strategies were effective. When asked whether a respondent's center perceives that tobacco smoking should be a deciding factor in destination therapy evaluations, nearly a third (15, 32%) responded in the affirmative.
While significant overlap exists among centers regarding treatments used for smoking cessation with left ventricular assist device patients, the most common treatments are not thought to be effective. While the current recommendations require tobacco smoking cessation in only bridge-to-transplant patients and not destination therapy patients, a number of centers disagree with the national guidelines and believe smoking should be prohibited in both populations.
吸烟是使用永久性左心室辅助装置患者发病和致残的主要原因。虽然已经研究了各种戒烟策略，但心室辅助装置中心实施成功戒烟计划的能力仍不确定。我们探讨了心室辅助装置中心采用的各种戒烟策略，并评估了这些策略的有效性及其在这些计划中的机构投资。
使用 Survey Monkey 创建了一个包含 37 个问题的在线自我报告调查，并在全球范围内进行了分发。我们调查了：（1）用于戒烟的计划策略；（2）受访者对这些策略有效性的看法；（3）这些疗法的管理结构；（4）对这些治疗方法的整体组织支持。
全球共有 47 个中心完成了调查。最常见的戒烟方法是药物治疗和尼古丁替代疗法（分别为 78%和 66%）。然而，只有大约一半（分别为 47%和 50%）的中心表示这些策略有效。当被问及受访者的中心是否认为吸烟应该成为终点治疗评估的决定因素时，近三分之一（15，32%）的人表示肯定。
尽管中心在用于左心室辅助装置患者戒烟的治疗方法方面存在显著重叠，但最常见的治疗方法并不被认为是有效的。虽然目前的建议仅要求在桥接移植患者中而不是在终点治疗患者中戒烟，但许多中心不同意国家指南，并认为吸烟应在这两个群体中都被禁止。
