Emmanuel Sam, Engelman Jared, Hayward Christopher Simon
Cardiology Department, St Vincent's Hospital, Sydney, Australia.
School of Medicine, University of New South Wales, Sydney, Australia.
Indian J Thorac Cardiovasc Surg. 2020 Aug;36(Suppl 2):247-255. doi: 10.1007/s12055-019-00891-2. Epub 2020 Feb 27.
Ventricular assist devices (VADs) have provided a temporising solution to many individuals with refractory heart failure (HF) while awaiting a suitable donor for heart transplantation which remains the gold standard in treatment. Many of the discussions around VADs involve ongoing morbidity; however, one aspect of VADs that is often overlooked is the utility of their log files. We decided to review the literature for mentions of the clinical utility of VAD log files.
A keyword search was utilised on PUBMED using the terms 'Ventricular Assist Device' and 'Log files'. Perhaps unsurprisingly, this search only yielded 4 results with further articles being discovered through the bibliography of these publications.
The 4 identified articles provided basic information on log files, particularly with reference to the HVAD. Logs can be categorised into three types-data (pump parameters), events (changes in parameters) and alarms (abnormal function). Using a combination of these logs, we can readily identify abnormal pump operation such as the development and progression of pump thrombosis, suction events and gastrointestinal bleeding. However, the research potential of log files was not discussed in these publications, particularly as it pertains to areas such as studying speed modulation and pulsatility in VADs.
VADs are an important staple in the treatment of patients with refractory HF. Log files provide a treasure-trove of information and knowledge that can be utilised for clinical benefit. Furthermore, log files provide an excellent tool for conducting research into device functionality. Current literature on the clinical utility of log files is sparse with much untapped potential.
心室辅助装置(VAD)为许多难治性心力衰竭(HF)患者提供了一种临时解决方案,同时等待合适的心脏移植供体,心脏移植仍是治疗的金标准。围绕VAD的许多讨论都涉及持续的发病率;然而,VAD经常被忽视的一个方面是其日志文件的实用性。我们决定回顾文献中提及的VAD日志文件的临床实用性。
在PUBMED上使用“心室辅助装置”和“日志文件”这两个关键词进行搜索。不出所料,这次搜索仅产生了4个结果,通过这些出版物的参考文献又发现了更多文章。
这4篇已识别的文章提供了关于日志文件的基本信息,特别是关于HeartWare心室辅助装置(HVAD)的信息。日志可分为三种类型——数据(泵参数)、事件(参数变化)和警报(功能异常)。通过综合使用这些日志,我们可以很容易地识别泵的异常运行情况,如泵血栓形成的发展和进展、抽吸事件和胃肠道出血。然而,这些出版物中没有讨论日志文件的研究潜力,特别是在研究VAD的速度调节和搏动性等领域。
VAD是治疗难治性HF患者的重要手段。日志文件提供了丰富的信息和知识宝库,可用于临床获益。此外,日志文件为研究设备功能提供了一个极好的工具。目前关于日志文件临床实用性的文献很少,有很大的未开发潜力。