mechanical support Flashcards
patient with LVAD with decreased PI and high pump power? LDH and bili up?
pump thrombosis
in what process is aortic balloon pump CI?
acute aortic insufficiency
immediate complications of LVAD?
right heart failure, device malposition, thombosis, suck down, bleeding
what is the only programmable parameter in a VAD?
pump speed
north south syndrome, what is it?
adequate native CO with worsening RF leading to a more distal mixing cloud, leading to upper body hypoxemia
how would one assess for north south syndrome?
comparing right and left radial arterial ABG and looking at post ox gas
changes to make to improve to improve north south?
changing to central cannulation, increasing ECMO flow, changing to VV ECMO if cardiac function has improved
2 mechanisms in which an IABP inflates?
EKG and aortic pressure
on EKG when does IABP inflate and deflate?
inflate mid t wave- start of diastole
deflate on R wave- start of systole
if using aortic pressure when does balloon inflate?
on dicrotic notch(aortic valve closure)
early balloon inflation can cause what?
increased afterload and inc myocardial oxygen demand
why does pulsatility index drop in pump thrombosis?
the thrombus is in the way of the LV contracting more through the impellar
treatment for pump thrombosis?
cna potentially use thrombolysis but definitive tx is pump exchange
suction event causes what mechanical complication?
contact between the LV wall and cannula causing VT, but VT itself can cause a suction event
mechanical parameters on suction event?
dec flow, dec PI
