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Left ventricular assist device withdrawal : ethical, psychological, and logistical challenges

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SLAVIN, Samuel D. | ALLEN, Larry A. | MCILVENNAN, Colleen K. | DESAI, Akshay S. | SCHAEFER, Kristen G. | WARRAICH, Haider J.

As left ventricular assist device (LVAD) technology continues to offer longer and better lives to patients with advanced heart failure, it also redefines how these patients die. This evolving dying process is unfamiliar to many clinicians and can be distressing for patients and their caregivers. No element of this process is more visceral or immediate than the act of withdrawing LVAD support, particularly for a patient who is awake and interactive. Despite ongoing improvement in survival and functional outcomes, LVAD patients frequently experience deaths characterized by distress, confusion, and a lack of control that fail to meet many of the criteria for high-quality end-of-life care.

http://dx.doi.org/10.1089/jpm.2019.0622

Voir la revue «JOURNAL OF PALLIATIVE MEDICINE, 23»

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