Chest compressions may be safe in arresting patients with left ventricular assist devices (LVADs).
BACKGROUND
The number of patients with left ventricular assist devices (LVADs) is increasing each year. Despite a lack of evidence, many emergency medical systems and hospitals have recommended against performing chest compressions in these patients. This deviation from conventional resuscitation algorithms is secondary to concern that chest compressions could dislodge the LVAD.


OBJECTIVE
To assess whether cannula dislodgment occurred in LVAD patients receiving chest compressions.


METHODS
We retrospectively analyzed the outcomes of all LVAD patients who received chest compressions for cardiac arrest over a four year period in a large urban hospital. Eight cases were reviewed for both cannula integrity and outcomes.


RESULTS
Using autopsy and adequate flow through device as proxy for intact inflow/outflow cannulas, none of the eight patients receiving chest compressions had cannula dislodgment. Four of the 8 patients had return of neurologic function.


CONCLUSIONS
In this small retrospective case series, standard chest compressions in patients with LVADs did not cause cannula dislodgment. More research is necessary to determine the utility of chest compressions in the LVAD population.
Sharp Memorial Hospital, 7901 Frost Street, San Diego, CA 92123, United States. Electronic address: zshinar@hotmail.com.
Zachary
Z
Shinar
Sharp Memorial Hospital, 7901 Frost Street, San Diego, CA 92123, United States.
Joseph
J
Bellezzo
Sharp Memorial Hospital, 7901 Frost Street, San Diego, CA 92123, United States.
Marcia
M
Stahovich
University of Toronto, 77 Browns Line, Suite 100, Toronto, ON M8W 3S2, Canada.
Sheldon
S
Cheskes
Sharp Memorial Hospital, 7901 Frost Street, San Diego, CA 92123, United States.
Suzanne
S
Chillcott
Sharp Memorial Hospital, 7901 Frost Street, San Diego, CA 92123, United States.
Walter
W
Dembitsky
D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006336:Heart Massage / Q000009:adverse effects; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
Cardiac arrest; Chest compressions; LVAD; Left ventricular assist devices