부산대학교 도서관

If a patient with a left ventricular assist device (LVAD) presents to the ED with a gastrointestinal bleed, the management can be complicated. LVAD patients are anticoagulated and often coagulopathic from the device itself, so gastrointestinal bleeding is a common presentation. Assessment of hemodynamics in an LVAD patient requires a Doppler to assess the mean arterial pressure as well as an interrogation of the LVAD controller. These patients are sensitive to decreases in preload and increases in afterload, so resuscitation should be tailored accordingly. Special consideration should be given to reversing anticoagulation in these patients, and the LVAD team should be contacted early and communicated with frequently.