In-hospital cardiopulmonary arrests in patients with left ventricular assist devices

Sonia Garg, Colby R. Ayers, Catherine Fitzsimmons, Dan Meyer, Matthias Peltz, Brian Bethea, William Cornwell, Faris Araj, Jennifer Thibodeau, Mark H. Drazner

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background Basic and advanced cardiac life support guidelines do not address resuscitation of patients with continuous-flow (CF) left ventricular assist devices (LVADs). As the population of LVAD patients increases, it becomes important to understand how to provide emergency care to such patients.

Methods and Results We retrospectively reviewed a consecutive series of patients with an implanted CF-LVAD who had an in-hospital cardiopulmonary arrest at our medical center from January 2011 to October 2013. We compared them with a matched cohort of patients without LVADs who had an in-hospital cardiopulmonary arrest during the same time period. Code documentation was used to determine arrest characteristics, perfusion assessment techniques, and time to cardiopulmonary resuscitation (CPR) initiation. There were 415 in-hospital arrests during the study period, and 4% (n = 16) occurred in patients with CF-LVADs. Response teams used various approaches to assess arterial perfusion, including palpation or Doppler of the arterial pulse and measurement of blood pressure by Doppler or arterial line. Nine of the 16 patients required CPR, but only 5 (56%) received CPR in <2 minutes. In the control group (n = 32) of patients without an LVAD, 22 received CPR, which was initiated within 2 minutes in all (100%) of the patients.

Conclusions Cardiopulmonary arrests in LVAD patients accounted for 4% of all arrests in our center. We identified important time delays in CPR initiation, highlighting the need to develop resuscitation guidelines for this patient population.

Original languageEnglish (US)
Pages (from-to)899-904
Number of pages6
JournalJournal of Cardiac Failure
Volume20
Issue number12
DOIs
StatePublished - Dec 1 2014

Fingerprint

Heart-Assist Devices
Heart Arrest
Cardiopulmonary Resuscitation
Resuscitation
Perfusion
Advanced Cardiac Life Support
Guidelines
Vascular Access Devices
Palpation
Emergency Medical Services
Documentation
Population
Blood Pressure

Keywords

  • cardiac arrest
  • CPR
  • LVADs
  • resuscitation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

In-hospital cardiopulmonary arrests in patients with left ventricular assist devices. / Garg, Sonia; Ayers, Colby R.; Fitzsimmons, Catherine; Meyer, Dan; Peltz, Matthias; Bethea, Brian; Cornwell, William; Araj, Faris; Thibodeau, Jennifer; Drazner, Mark H.

In: Journal of Cardiac Failure, Vol. 20, No. 12, 01.12.2014, p. 899-904.

Research output: Contribution to journalArticle

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AU - Bethea, Brian

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AU - Araj, Faris

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AU - Drazner, Mark H.

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N2 - Background Basic and advanced cardiac life support guidelines do not address resuscitation of patients with continuous-flow (CF) left ventricular assist devices (LVADs). As the population of LVAD patients increases, it becomes important to understand how to provide emergency care to such patients.Methods and Results We retrospectively reviewed a consecutive series of patients with an implanted CF-LVAD who had an in-hospital cardiopulmonary arrest at our medical center from January 2011 to October 2013. We compared them with a matched cohort of patients without LVADs who had an in-hospital cardiopulmonary arrest during the same time period. Code documentation was used to determine arrest characteristics, perfusion assessment techniques, and time to cardiopulmonary resuscitation (CPR) initiation. There were 415 in-hospital arrests during the study period, and 4% (n = 16) occurred in patients with CF-LVADs. Response teams used various approaches to assess arterial perfusion, including palpation or Doppler of the arterial pulse and measurement of blood pressure by Doppler or arterial line. Nine of the 16 patients required CPR, but only 5 (56%) received CPR in <2 minutes. In the control group (n = 32) of patients without an LVAD, 22 received CPR, which was initiated within 2 minutes in all (100%) of the patients.Conclusions Cardiopulmonary arrests in LVAD patients accounted for 4% of all arrests in our center. We identified important time delays in CPR initiation, highlighting the need to develop resuscitation guidelines for this patient population.

AB - Background Basic and advanced cardiac life support guidelines do not address resuscitation of patients with continuous-flow (CF) left ventricular assist devices (LVADs). As the population of LVAD patients increases, it becomes important to understand how to provide emergency care to such patients.Methods and Results We retrospectively reviewed a consecutive series of patients with an implanted CF-LVAD who had an in-hospital cardiopulmonary arrest at our medical center from January 2011 to October 2013. We compared them with a matched cohort of patients without LVADs who had an in-hospital cardiopulmonary arrest during the same time period. Code documentation was used to determine arrest characteristics, perfusion assessment techniques, and time to cardiopulmonary resuscitation (CPR) initiation. There were 415 in-hospital arrests during the study period, and 4% (n = 16) occurred in patients with CF-LVADs. Response teams used various approaches to assess arterial perfusion, including palpation or Doppler of the arterial pulse and measurement of blood pressure by Doppler or arterial line. Nine of the 16 patients required CPR, but only 5 (56%) received CPR in <2 minutes. In the control group (n = 32) of patients without an LVAD, 22 received CPR, which was initiated within 2 minutes in all (100%) of the patients.Conclusions Cardiopulmonary arrests in LVAD patients accounted for 4% of all arrests in our center. We identified important time delays in CPR initiation, highlighting the need to develop resuscitation guidelines for this patient population.

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