experience –
Blood Pressure and LVADRating: (votes: 8) Just curious. Thanks! The most accurate way is to use a doppler and a cuff with a needle pressure gauge. Comment:
depends upon the lvad -- there are still a few pulsitile vads around (very few) that you can use non-invasive cuffs on. the rest -- arterial lines or a doppler and a good old fashioned sphygmomanometer.
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Agreed.....A regular sphygmomanometer and a doppler....http://www.thoratec.com/downloads/LVAD-FactSheet.pdf
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Pulsitile VADs haven't quite gone the way of the dinosaurs just yet. You can always go by flow rates if all else fails. That's the main thing.
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There is also a special cuff made for LVAD patients, I think it's by the Terumo company (they make vads) that works great. Problem is, it's expensive and not all patients get them. We use dopplers with cuffs on the floor, works fine.
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In the ICU we usually use the electronic cuff and record the mean, if it can get a reading. Usually this works, if not we Doppler them. Once they get to the floor they get a sphymomanometer and Doppler read...pain in the butt when there are 4 VADs and 1-2 Dopplers....glad I'm in the ICU. Some of the Heartmate II folks do still have aortic valve closure and we can get pulses as well...but even if not we can usually get an electronic cuff read where the mean matches the Doppler decently.
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Thank you all for your responses! I'm a cardiac nurse, but we don't do LVADs in my facility. A family member of one of our patients had one, and was kind enough to let us look at it and ask questions, but that was one question I didn't think to ask.
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I work in a hospital where we implant at least 2-3 lvads a day, so needless to say, we have ALOT of them....just a regular blood pressure cuff is fine....sometimes you will get a blood pressure with a systolic and diastolic but sometimes you will not and only get a Mean....i don't thinks its possible to use a Doppler to check a bp on these pts (honestly I've never tried either) bc their pump is a continuous flow regardless and depending in which pump they have there may or may not be pulsatility...
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