Table 2.
Instruction to reduce the risk of adverse events when early mobilization starts in LVAD patients.
| •Assessment (persistence of VAD-related and HF symptoms, medications and particular treatments, i.e., need for continuous or intermittent infusions, ventilator settings or oxygen requirements prescribed) |
| •Recent and past medical history, and level of exercise capacity previous to disease state. |
| •Mental status and cognitive ability. |
| •Vital signs and risk of cardiovascular instability. |
| •Screen range of motion, coordination, balance, strength, endurance, functional capacity. |
| •Haemochromocytometric, ionic and renal functional assessment: start EM and/or ET when hemoglobin >9 g/dl, sodium >130 mEq/L, potassium >3.8 mEq/L, and/or creatininaemia <1.9 mg/dl. |
| •Follow sternotomy and skin integrity. |
| •Patients should always wear a driveline stabilization belt during EM and/or ET. |
| •The patient should have his/her travel bag nearby at all times. |
| Promote: |
| 1. Low-to-moderate intensity dynamic large muscle group work. |
| 2. Walk & talk' approach is suggested. |
| 3. Organize an appropriate place to put monitor, console-controller and batteries; the VAD equipment location should not impede emergency procedures during ET. |
LVAD, left ventricular assist device; HF, heart failure; EM, early mobilization; ET, exercise training.