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.