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My name is Patrik Hutzel from intensivecarehotline.com, where we instantly improve the lives for families of critically ill patients in intensive care, so that you can make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment always, even if you’re not a doctor or a nurse in intensive care.

Today, I want to answer a very important question that I get all the time, “When does a critically ill patient in ICU need a ventricular assist device?” I’ll also explain the difference between an LVAD, which is a left ventricular assist device, and a RVAD, which is a right ventricular assist device.

So, let’s look at part one.

What is a ventricular assist device (VAD)?

VAD is a mechanical pump that helps the failing heart circulate blood. It’s used in ICU for patients with severe heart failure or cardiogenic shock when the heart can’t maintain blood flow on its own. It takes over part or all of the heart’s pumping function.

Example, let’s say a loved one has had a massive heart attack, and even with medications and an intra-aortic balloon pump, their blood pressure and circulation can’t be maintained, that’s when the ICU team may talk about a VAD.

Next, when does a patient in ICU need a VAD? When the heart can’t pump blood effectively despite all medications and support. Conditions include massive heart attack leading to heart failure, post cardiac surgery, heart failure, cardiogenic shock, as a bridge to recovery, bridge to a heart transplant, or bridge to a decision, also after cardiac arrest. Often a VAD is the last step before death or recovery if everything else has failed.

In other words, a patient in ICU might need a VAD when they are in cardiogenic shock, their heart is not responding to inotropes and vasopressors, and doctors are saying, “We’ve done everything we can medically,” that’s when mechanical support like a VAD becomes necessary.

Next, LVAD versus RVAD explained.

LVAD (left ventricular assist device)

• Supports the left ventricle of the heart, the main chamber that pumps blood to the body
• Used for left-sided heart failure, post heart attack, cardiomyopathy, cardiac surgery – can be temporary or permanent
• Can serve as a bridge to a transplant, bridge to recovery, destination therapy for patients not eligible for transplant

RVAD (right ventricular assist device)

• Supports the right ventricle which pumps blood to the lungs
• Used for right heart failure after heart surgery, pulmonary embolism or pulmonary hypertension
• Usually temporary until the right ventricle recovers.

Then, there’s the BiVAD.

When both sides fail, BiVAD (bi-ventricular assist device) support may be needed. So, if your loved one’s left side of the heart is failing, they may need an LVAD. If the right side is failing, they may need an RVAD. Sometimes both are failing and the ICU may use a BiVAD. These devices can literally keep someone alive while their heart recovers or until a transplant is possible.

Let’s now also look at ventricular assist device versus ECMO (Extracorporeal Membrane Oxygenation).

Both are mechanical circulatory supports, VAD helps with pumping function only, ECMO helps with heart and lung support. Families often ask me what’s the difference between ECMO and VAD? Think of it this way. VAD is heart support only, and ECMO is heart and lung support.

Key takeaways from today’s discussion:

VAD is considered when all medical therapies fail for heart failure. LVAD supports the left ventricle of the heart, RVAD supports the right ventricle of the heart. It can be temporary, long-term, or even permanent.

Always ask the ICU team whether it’s a bridge to recovery, bridge to a transplant, or destination therapy. Never make any rushed decisions. Always get second opinions and full explanations.

Also, if your loved one is on a VAD, whether it’s LVAD, RVAD or BiVAD, they will always need anticoagulation therapies such as a heparin infusion or they need to be on warfarin.

So, if your loved one is in ICU and the doctors are talking about a ventricular assist device, whether that’s an LVAD, RVAD, BiVAD, or even ECMO and you’re not sure what it all means, contact us at intensivecarehotline.com because we’ll help you to make informed decisions, have peace of mind, control, power, and influence, making sure that your loved one always gets best care and treatment, even in the face of critical illness.

I have worked in critical care nursing for 25 years in three different countries where I worked as a nurse manager for over 5 years in intensive care. I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can very confidently say that we have saved many lives with our consulting and advocacy because of our insights. You can verify that on our testimonial section at intensivecarehotline.com. You can verify it on our intensivecarehotline.com podcast section where we have done client interviews because our advice is absolutely life changing.

The biggest challenge for families in intensive care is simply that they don’t know what they don’t know. They don’t know what to look for. They don’t know what questions to ask. They don’t know their rights, and they don’t know how to manage doctors and nurses in intensive care.

That’s why we help you to improve your life instantly, making sure you make informed decisions, have peace of mind, control, power, and influence, making sure your loved one gets best care and treatment always. That’s why you can join a growing number of members and clients that we have helped over the years, saving their loved ones’ lives.

That’s why I do one on one consulting and advocacy over the phone, Zoom, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I handhold you through this once in a lifetime situation that you simply cannot afford to get wrong. When I talk to families directly, I also talk to doctors and nurses directly, asking all the questions that you haven’t even considered asking but must be asked when you have a loved one critically ill in intensive care.

I also represent you in family meetings with intensive care teams.

We also do medical record reviews in real time so that you can get a second opinion in real time. We also do medical record reviews after intensive care if in case you have unanswered questions, if you need closure, or if you are suspecting medical negligence.

We also have a membership for families of critically ill patients in intensive care, and you can become a member if you go to intensivecarehotline.com, if you click on the membership link, or if you go to intensivecaresupport.org directly. In the membership, you have access to me and my team, 24 hours a day, in the membership area and via email, and we answer all questions intensive care related. In the membership, you also have exclusive access to 21 eBooks and 21 videos that I have personally written and recorded. All of that will help you to improve your life instantly, make informed decisions, have peace of mind, control, power and influence, making sure your loved one gets best care and treatment always.

All of that you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected] with your questions.

If you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care. Click the like button, click the notification bell, share the video with your friends and families, and comment below what you want to see next, what questions and insights you have from this video.

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Thank you so much for watching.

This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.

Take care for now.

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