LVADs and proning

  • 1.  LVADs and proning

    Posted 03-24-2020 09:13
    Has anyone had experience with proning LVAD patients with ARDS related to COVID infection or other? If not do you hypothesize this would have hemodynamic implications in an LVAD patient?


    Noah Moss
    Mount Sinai Hospital
    New York NY
    (646) 483-9701

  • 2.  RE: LVADs and proning

    Posted 03-28-2020 06:22
      |   view attached

    Prone positioning should be considered as a rescue maneuver to facilitate the redistribution of pulmonary blood flow, rather than for opening collapsed areas. Be aware that long-term prone positioning/supine cycles is of very little benefit in patients with high compliance, and it leads to high levels of stress and fatigue in the personnel.
    This has been stated by Dr. Gattinoni (master of such a kind of treatment) as herein attached.
    It depends on the category of COVID-19 disease. Only  those patients who have also self-inflicted ventilator induced lung-injury with subsequent decrease in compliance (values lower than 50 ml/cmH2O) and edema in the lower lobes, as seen in CT scans. Those patients present a pattern similar to ARDS and they benefit of PEEP and prone positioning, paying attention in variations of ScVOand PaCO2.
    ... additionally you may suction LVAD events.

    Antonio Loforte

    Bologna S. Orsola University Hospital, Italy

    Antonio Loforte, MD, PhD

    Bologna S. Orsola University Hospital, Italy
    +39 051 2149043
    +39 338 4395425