Moscato Francesco, Gross Christoph, Maw Martin, Schlöglhofer Thomas, Granegger Marcus, Zimpfer Daniel, Schima Heinrich
Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.
Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria.
Ann Cardiothorac Surg. 2021 Mar;10(2):221-232. doi: 10.21037/acs-2020-cfmcs-218.
Technological progress of left ventricular assist devices (LVADs) towards rotary blood pumps and the optimization of medical management contributed to the significant improvements in patient survival as well as LVAD support duration. Even though LVAD therapy is now well-established for end-stage heart failure patients, the long-term occurrence of adverse events (AE) such as bleeding, infection or stroke, still represent a relevant burden. An early detection of AE, before onset of major symptoms, can lead to further optimization of patient treatment and thus mitigate the burden of AE. Continuous patient monitoring facilitates identification of pathophysiological states and allows anticipation of AE to improve patient management. In this paper, methods, algorithms and possibilities for continuous patient monitoring based on LVAD data are reviewed. While experience with continuous LVAD monitoring is currently limited to a few centers worldwide, the pace of developments in this field is fast and we expect these technologies to have a global impact on the well-being of LVAD patients.
左心室辅助装置(LVAD)向旋转血泵的技术进步以及医疗管理的优化,促成了患者生存率和LVAD支持时长的显著提高。尽管LVAD疗法目前在终末期心力衰竭患者中已得到充分确立,但出血、感染或中风等不良事件(AE)的长期发生,仍然是一个相当大的负担。在主要症状出现之前早期检测AE,可进一步优化患者治疗,从而减轻AE的负担。持续的患者监测有助于识别病理生理状态,并能预测AE以改善患者管理。本文综述了基于LVAD数据进行持续患者监测的方法、算法和可能性。虽然目前全球仅有少数几个中心有持续LVAD监测的经验,但该领域的发展步伐很快,我们预计这些技术将对LVAD患者的健康产生全球影响。