Palliative care clinicians caring for patients before and after continuous flow-left ventricular assist device

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WORDINGHAM, Sara E. | MCILVENNAN, Colleen K. | FENDLER, Timothy J. | BEHNKEN, Amy L. | DUNLAY, Shannon M. | KIRKPATRICK, James N. | SWETZ, Keith M.

Left ventricular assist devices (LVADs) are an available treatment option for carefully-selected patients with advanced heart failure. Initially developed as a bridge to transplantation, LVADs are now also offered to patients ineligible for transplantation as destination therapy (DT). Individuals with a DT-LVAD will live the remainder of their lives with the device in place. While survival and quality of life improve with LVADs compared to medical therapy, complications persist including bleeding, infection, and stroke. There has been increased emphasis on involving palliative care specialists in LVAD programs, specifically the DT-LVAD population, from the pre-implantation process through the end of life. Palliative care specialists are well-poised to provide education, guidance and support to patients, families, and clinicians throughout the LVAD journey. This manuscript addresses the complexities of the LVAD population, describes key challenges faced by palliative care specialists, and discusses opportunities for building collaboration between palliative care specialists and LVAD teams.

http://dx.doi.org/10.1016/j.jpainsymman.2017.07.007

Voir la revue «JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 54»

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