• Waqas Akhtar, Veronica Rial Baston, Marius Berman, Sai Bhagra, Colin Chue, Charles D Deakin, Jonathan R Dalzell, Joel Dunning, John Dunning, Roy S Gardner, Kristine Kiff, Shishir Kore, Sern Lim, Guy MacGowan, Ian Naldrett, Marlies Ostermann, Sofia Pinto, Stephen Pettit, GilFernando RiesgoFRHarefield Hospital, London, UK., Alex Rosenberg, Antonio Rubino, Rana Sayeed, Joao Sequeira, Neil Swanson, Steven Tsui, Christopher Walker, Stephen Webb, Andrew Woods, Rajamiyer Ventkateswaran, and Christopher T Bowles.
• Harefield Hospital, London, UK. waqas.akhtar@nhs.net.
• Intensive Care Med. 2024 Apr 1; 50 (4): 493501493-501.

AbstractAn implantable left ventricular assist device (LVAD) is indicated as a bridge to transplantation or recovery in the United Kingdom (UK). The mechanism of action of the LVAD results in a unique state of haemodynamic stability with diminished arterial pulsatility. The clinical assessment of an LVAD recipient can be challenging because non-invasive blood pressure, pulse and oxygen saturation measurements may be hard to obtain. As a result of this unusual situation and complex interplay between the device and the native circulation, resuscitation of LVAD recipients requires bespoke guidelines. Through collaboration with key UK stakeholders, we assessed the current evidence base and developed guidelines for the recognition of clinical deterioration, inadequate circulation and time-critical interventions. Such guidelines, intended for use in transplant centres, are designed to be deployed by those providing immediate care of LVAD patients under conditions of precipitous clinical deterioration. In summary, the Joint British Societies and Transplant Centres LVAD Working Group present the UK guideline on management of emergencies in implantable LVAD recipients for use in advanced heart failure centres. These recommendations have been made with a UK resuscitation focus but are widely applicable to professionals regularly managing patients with implantable LVADs.© 2024. The Author(s).

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