Implementing Routine Palliative Care Consultation Before LVAD Implantation: A Single Center Experience

Salomon, Say; Frankel, Hilary; Chuang, Elizabeth; Eti, Serife; Selwyn, Peter A.

doi:10.1016/j.jpainsymman.2017.12.490

Cited by 21 publications

(12 citation statements)

References 13 publications

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“…Seven relevant studies were selected for review. Four studies used a mixed‐methods design: Salomon, Frankel, Chuang, Eti, and Selwyn (), Nakagawa, Yuzefpolskaya, Colombo, Naka, and Blinderman (), Metzger, Song, Ward, et al () and Metzger Song, and Devane‐Johnson (), Swetz, Freeman, et al (). Metzger, Song, Ward, et al, ; Metzger, Song, & Devane‐Johnson, was published in two parts, separately reporting the results of a randomised controlled trial and a qualitative study.…”

Section: Resultsmentioning

confidence: 99%

“…Inevitably, there will be some patients who require urgent LVAD implantation, and so pre‐implantation discussion will not be possible. Nevertheless, the most frequent reason that ACP was not completed was that by omission; a request for consultation was never made (Nakagawa et al, ; Verdoorn et al, and Salomon et al, ).…”

Section: Resultsmentioning

confidence: 99%

“…Salomon et al () describe a case of a patient who had LVAD implanted urgently and prior to ACP discussion. When his condition began to deteriorate and the palliative team was consulted the patient raised the idea of LVAD deactivation.…”

Section: Resultsmentioning

confidence: 99%

“…The rate of documented ACP discussions with LVAD patients varied between 28.9% and 77% with higher prevalence observed in LVAD‐centres which implemented routine LVAD specific ACP before the device was implanted. LVAD specific ACP is associated with increased rate of AD available in patients’ medical notes (Nakagawa, et al, ; Salomon et al, ; Swetz, Freeman, et al, ; Verdoorn, et al, ). These directives however do not always mention LVAD (Verdoorn et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…ACP empowers patients to clarify and inform their caregivers what their preferences would be if they suffered severe incurable complications and were not able to make a decision for themselves. Patients and relatives commonly find these conversations difficult but beneficial (Brush et al, ; Metzger, Song, & Devane‐Johnson, ; Salomon et al, ).…”

Section: Discussionmentioning

confidence: 99%

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To explore the prevalence and outcomes of advance care planning for patients with left ventricular assist devices: A review

Delmaczynska

Newham

2019

Journal of Clinical Nursing

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Aims and objectives To explore the prevalence and outcomes of advance care planning for patients with left ventricular assist devices: a review. Background End‐stage heart failure is associated with significant symptom burden at rest. Left ventricular assist devices are not curative; nevertheless, they alleviate symptoms and prolong survival. Evidence suggests that most patients with left ventricular assist devices and their families do not have open discussions regarding end‐of‐life wishes until catastrophic complications arise. Therefore, it is important to understand reasons for this, so healthcare professionals such as nurses can facilitate the process. Design A mixed‐studies integrative review with a narrative synthesis of the evidence. PRISMA guidelines were followed for reporting systematic qualitative reviews. Method A search of four electronic data in January 2018 and a hand search yielded 139 citations; seven studies met the review eligibility criteria. Methodological quality of the selected studies was evaluated, and data were extracted and compiled. Results Three themes were identified: prevalence and feasibility of advanced care planning, advance care planning developed for patients with device support, patients’ and caregivers’ perceptions of advanced care planning discussions. Advanced care planning is underused routinely implemented in left ventricular device centres. Pre‐implantation advanced care planning is feasible and results in the highest rate of documented advance decisions which are useful for both patients and their loved ones in cases of complications. Conclusion Strong evidence that left ventricular assist‐specific advanced care planning is recommended for all left ventricular assist device patients to enable their treatment preferences in case of incurable complications. Palliative care services should collaborate with nurses in designing and facilitating advanced care planning for delisted transplant patients. Patients with left ventricular devices awaiting heart transplant and those waiting for myocardium healing are underrepresented in the current studies. Research on the optimal timing of advanced care planning in these groups of patients is indicated. Relevance for clinical practice There is a need for improved approaches to advanced care planning for and with people with left ventricular devices.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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To explore the prevalence and outcomes of advance care planning for patients with left ventricular assist devices: A review

Delmaczynska

Newham

2019

Journal of Clinical Nursing

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HFA of the ESC position paper on the management of LVAD‐supported patients for the non‐LVAD specialist healthcare provider Part 3: at the hospital and discharge

et al. 2021

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The growing population of left ventricular assist device (LVAD)‐supported patients increases the probability of an LVAD‐ supported patient hospitalized in the internal or surgical wards with certain expected device related, and patient‐device interaction complication as well as with any other comorbidities requiring hospitalization. In this third part of the trilogy on the management of LVAD‐supported patients for the non‐LVAD specialist healthcare provider, definitions and structured approach to the hospitalized LVAD‐supported patient are presented including blood pressure assessment, medical therapy of the LVAD supported patient, and challenges related to anaesthesia and non‐cardiac surgical interventions. Finally, important aspects to consider when discharging an LVAD patient home and palliative and end‐of‐life approaches are described.

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Ethics: When to Turn Off the VAD

Grant¹,

Angelos

2019

Difficult Decisions in Surgery: An Evidence-Based Approach

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Implementing Routine Palliative Care Consultation Before LVAD Implantation: A Single Center Experience

Cited by 21 publications

References 13 publications

To explore the prevalence and outcomes of advance care planning for patients with left ventricular assist devices: A review

To explore the prevalence and outcomes of advance care planning for patients with left ventricular assist devices: A review

HFA of the ESC position paper on the management of LVAD‐supported patients for the non‐LVAD specialist healthcare provider Part 3: at the hospital and discharge

Ethics: When to Turn Off the VAD

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