Mechanical life support algorithm developed by simulation for inpatient emergency management of recipients of implantable left ventricular assist devices

Akhtar, W; Gamble, B; Kiff, K; Wypych-Zych, A; Raj, B; Takata, J; Gil, FR; Hurtado, A; Rosenberg, A; Bowles, CT

Journal article

Mechanical life support algorithm developed by simulation for inpatient emergency management of recipients of implantable left ventricular assist devices

Abstract:: Background
Published guidance concerning emergency management of left ventricular assist device (LVAD) recipients is both limited and lacking in consensus which increases the risk of delayed and/or inappropriate actions.
Methods
In our specialist tertiary referral centre we developed, by iteration, a novel in-hospital resuscitation algorithm for LVAD emergencies which we validated through simulation and assessment of our multi-disciplinary team. A Mechanical Life Support course was established to provide theoretical and practical education combined with simulation to consolidate knowledge and confidence in algorithm use. We assessed these measures using confidence scoring, a key performance indicator (the time taken to restart LVAD function) and a multiple-choice question (MCQ) examination.
Results
The mean baseline staff confidence score in management of LVAD emergencies was 2.4 ± 1.2 out of a maximum of 5 (n = 29). After training with simulation, mean confidence score increased to 3.5 ± 0.8 (n = 13).Clinical personnel who were provided with the novel resuscitation algorithm were able to reduce time taken to restart LVAD function from a mean value of 49 ± 8.2 seconds (pre-training) to 20.4 ± 5 seconds (post-training) (n = 42, p < 0.0001).The Mechanical Life Support course increased mean confidence from 2.5 ± 1.2 to 4 ± 0.6 (n = 44, p < 0.0001) and mean MCQ score from 18.7 ± 3.4 to 22.8 ± 2.6, out of a maximum of 28 (n = 44, p < 0.0001).
Conclusion
We present a simplified LVAD Advanced Life Support algorithm to aid the crucial first minutes of resuscitation where basic interventions are likely to be critical in assuring good patient outcomes.

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

Akhtar, W., Gamble, B., Kiff, K., Wypych-Zych, A., Raj, B., Takata, J., Gil, F. R., Hurtado, A., Rosenberg, A., & Bowles, C. T. (2022). Mechanical life support algorithm developed by simulation for inpatient emergency management of recipients of implantable left ventricular assist devices. Resuscitation Plus, 10, 100254–100254.

MLA Style

Akhtar, W, et al. “Mechanical Life Support Algorithm Developed by Simulation for Inpatient Emergency Management of Recipients of Implantable Left Ventricular Assist Devices.” Resuscitation Plus, vol. 10, 2022, pp. 100254–54.

Chicago Style

Akhtar, W, B Gamble, K Kiff, et al. 2022. “Mechanical Life Support Algorithm Developed by Simulation for Inpatient Emergency Management of Recipients of Implantable Left Ventricular Assist Devices.” Resuscitation Plus 10: 100254–54.
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