الفهرس 
What Anesthiologists Should Know About VADs?Only 14 pages are availabe for public view
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Abstract
Abstract
Full information about the device obtained from the LVAD team, including the current settings, the duration of the implantation, and any complications. The preoperative evaluation should also focus on identifying any other underlying end-organ dysfunction as renal and hepatic dysfunction, which can be common in DT patients. Preoperative full laboratory studies should be available. Patients should have blood available before the procedure. Patients should be admitted to the hospital in advance of their procedure for bridging of their anticoagulation from warfarin to heparin. However, in emergent cases, fresh frozen plasma may be necessary to partially reverse the effects of a patient’s anticoagulation. Because of the risk of LVAD thrombosis, full reversal of a patient’s anticoagulation should be avoided. the degree of anticoagulation reversal should be agreed by the surgical, anesthesia, and LVAD teams.
LVAD Preparation, LVADs can be powered via batteries or a base/module that plugs into a standard power outlet, it is advisable for even the shortest procedures to power the LVAD from its base/module. However, batteries should be available immediately in case of an equipment or power failure. An LVAD’s base/module also allows monitoring of the LVAD’s pump speed and flow rate. The electrosurgical unit grounding pad should be placed in such a manner that the path of the electrical current from the electrosurgical unit does not go through the LVAD. many of these patients also have automated internal cardioverter- defibrillators (AICDs), which should be turned off just before coming to the operating room, and external defibrillator pads should be applied.
All LVAD patients should have an arterial catheter placed for blood pressure monitoring, the relative lack of pulsatile blood flow may make the pulse oximeter does not work or to be inaccurate, serial arterial blood gas measurements or cerebral oximetry have been used as alternatives. According to the patient’s right ventricular function, either a central venous catheter or a pulmonary artery catheter should be used to monitor preload and right ventricular function. Intraoperative transesophageal echocardiography (TEE) also recommended.
Keywords: Pneumatic Vad - Systemic Vascular Resistance- Ventricular Assist Device- Lactate Dehydrogenase- Destination Therapy Cardiopulmonary Bypass