Page 3 - VAD Guidelines

Pediatric Ventricular Assist Device (VAD) Guidelines

Contents

Preface .......................................................................................................................................................... 2

When to consider VAD support .................................................................................................................... 6
Device Terminology ...................................................................................................................................... 6
VAD Device Types & Selection ...................................................................................................................... 6
Algorithm for Mechanical Support in Acute Heart Failure ....................................................................... 7

Pre-Implant Evaluation ................................................................................................................................. 7
Device Implantation ...................................................................................................................................... 8
OR & Device Considerations ..................................................................................................................... 8

Pre-surgical Device Implant Huddle .......................................................................................................... 8
Intraoperative Optimization of Device Settings........................................................................................ 8
VAD Alarms and Malfunctions ...................................................................................................................... 9

Initial ICU Support (First 48 hours).............................................................................................................. 10
Anticoagulation ....................................................................................................................................... 10
Chest Tube .............................................................................................................................................. 10

Fluid Management .................................................................................................................................. 10
Hemostasis .............................................................................................................................................. 10
Hypertension ........................................................................................................................................... 11
Infection Prophylaxis............................................................................................................................... 11

RV support .............................................................................................................................................. 11
Sedation .................................................................................................................................................. 11
Ventilation ............................................................................................................................................... 11

Ongoing ICU/Floor Management ................................................................................................................ 12
Anticoagulation ....................................................................................................................................... 12
Imaging Investigations ............................................................................................................................ 12

Rounding Checklist .................................................................................................................................. 13
VAD Adverse Events .................................................................................................................................... 14
Bleeding .................................................................................................................................................. 14

Cardiac Tamponade ................................................................................................................................ 14
Hemolysis ................................................................................................................................................ 14
Hypertension ........................................................................................................................................... 15
Infection: ................................................................................................................................................. 16

Inflammation ........................................................................................................................................... 17

Updated 3/24/2019 page 3