Page 9 - VAD Guidelines
P. 9

Pediatric Ventricular Assist Device (VAD) Guidelines

               VAD Alarms and Malfunctions
               Assessment of VAD alarms should begin with patient assessment.  Evaluate the patient to identify
               whether the alarm condition has created (or might have been caused by) changes in patient arousal,
               hemodynamics, etc… Understanding whether and how the patient’s clinical condition has changed is
               critical in evaluating the potential causes for alarms, especially alarms related to VAD flows. For VADs,
               the following represents only a portion of the most common alarms, for a full list of alarms and
               appropriate responses, refer to section on individual devices and the VAD folder on the Children’s
               SharePoint Drive.
               Low-flow alarms are the most common alarms encountered. On all devices, these may result from any
               of the following circumstances:
                1.  Decreased preload
                       a.  Hypovolemia
                       b.  Right ventricular failure (during LVAD support)
                       c.  Pulmonary arterial hypertension (during LVAD support)
                2.  Pericardial tamponade
                3.  Increased afterload

               Treatment will depend on underlying cause, clinical evaluation is required, including echocardiography
               as needed to assess preload and right ventricular function and to rule-out tamponade.

               Updated 3/24/2019                                                                       page 9
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