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Anesthetic Management of a Patient with Continuous-flow (Nonpulsatile) LVAD

Anesthetic Management of a Patient with Continuous-flow (Nonpulsatile) LVAD. Blood pressure assessment is challenge # 1: Oscillometry may be worthless (or may obtain MAP only) Doppler helps: First signal is “truncated” SAP Low threshold for arterial lines: May need ultrasound

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Anesthetic Management of a Patient with Continuous-flow (Nonpulsatile) LVAD

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  1. Anesthetic Management of a Patient with Continuous-flow (Nonpulsatile) LVAD • Blood pressure assessment is challenge # 1: • Oscillometry may be worthless (or may obtain MAP only) • Doppler helps: First signal is “truncated” SAP • Low threshold for arterial lines: May need ultrasound • Can dial back RPMs to increase pulse pressure temporarily for arterial line placement • SPO2: Non-starter if no pulse. Consider cerebral oximeter • Most chronic LVAD patients do have a pulse, but low pulse pressure

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