| HEARTWARE | NAME THAT VAD! | BERLIN HEART | HEARTMATE II | ANTICOAGULATION |
|---|---|---|---|---|
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What is THE PACIFIER?
SILENCES THE SYSTEM CONTROLLER AND NEVER GOES HOME WITH THE PATIENT!!!!
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What is Heartware?
Make sure Y'all update that HCT on this device at least daily and as needed.
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What is filling (Diastole)? Recall that incomplete filling is okay as long as hemodynamics are stable and there is good clinical cardiac output.
When the membrane is CONVEX, VAD is doing this.
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What is the speed?
The only adjustable parameter on the Heartmate II Device.
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What are drawing only from Heparin Naive lines and or Venipunctures. Lines that have NEVER been exposed to Heparin infusion or even a Heparin flush.
All ANTICOAGULATION LABS for our VAD population must be drawn in this manner.
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What is Flow Pulsatility?
The DIFFERENCE between the minimum (diastole) and maximum (systole) of the flow waveform.
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What is the Berlin Heart?
The Maker of this VAD only guarantees the Battery System will only last 30 minutes on this device. So be cognizant when taking your patient on an excursion!
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What is EJECTION (Systole)? Recall complete ejection is needed to prevent thromboses!
When the membrane is CONCAVE, VAD is doing this.
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What is a RAMP study?
This diagnostic study is used to determine the optimal fixed speed and the desired level of cardiac support for each patient.
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What is the Anti-Xa level?
Patient's on Low Molecular Weight Heparin such as Enoxaparin will have this test drawn 4 hours after administration of the the drug.
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What are the recommended alarm parameter settings for the Heartware HVAD? BUT NEVER below 2 Liters unless MDs write order.
2 ABOVE (Power Trend) and 2 Below (Flow Trend) Suction Alarms OFF
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What is the Berlin Heart? The only device that we are allowed to do compressions on currently.
When this VAD stops and if your patient is UNSTABLE you best start some good CPR.
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What is Separate Mode? Allows both the RVAD and LVAD to independent rates. Parameters can be set freely for each pump.
The most common BiVAD mode the Berlin Heart is set to.
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What are Speed, Power, Flow, and PI (Pulsatility Index)?
The 4 parameters that are followed on the system monitor.
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What is the HAL? ( Heparin Activity Level)
When patient's are on Heparin Infusion this is our preferred monitoring test.
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What is a Suction Detection (Event)?
A negative deflection on the flow waveform may indicate this is occurring.
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What is the Heartware?
The only device we currently use for our larger patient population (Greater than 50 kg) that can serve as a RVAD AND LVAD combined (BiVAD Support).
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Thrombosis/Obstruction, Ejection Pressure set too low, Set % systole is too low, VAD rate too low, Outflow cannula kinked/obstruction, Pneumatic Drive Line kinked, SVR or PVR too high, inadequate pharmacologic support.
At least 4 things that can cause incomplete ejection.
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What is PI (Pulsatility Index) Recall normal is about 3-6. Reflects native contractility.
The measurement of flow pulse THROUGH the pump.
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What is the INR?
When patient's are on Coumadin (Warfarin) therapy what test is used to monitor activity?
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What is an INR of 1.5 to 2.5? Goal INR is 2-2.5 after day 14 assuming no significant bleeding.
The Goal INR up until POSTOPERATIVE DAY 14.
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What is the Heartmate II?
This Device employs synthetic Ruby Bearings lubricated by the blood itself.
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What is at least 80-100 mm HG
The systolic drive pressure should be set at least this many mm HG above the patient's systolic pressure to ensure adequate emptying of the VAD.
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What is 6000-15000 RPMS?
The speed range for the Heartmate II.
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What are FFP, Platelets, Vitamin K, FEIBA, Recombinant Factor VIIa, Prothrombin Complex (PCC)?
At least 2 common reversal agents/products to anticoagulation therapy for elective reversal (Patient going in for transplant) or an Acute Bleed.
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