Improving anticoagulation of patients with an implantable left ventricular assist device.
other · Level V
Where this comes from
- Record sourced from PubMed, PMID 30306143.
- Also identified by DOI 10.1136/bmjoq-2017-000250 and PMC identifier 6173227.
- Licence recorded as CC BY-NC.
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Abstract
Patients supported with implantable left ventricular assist devices (LVAD) have a significant risk of bleeding and thromboembolic complications. All patients require anticoagulation with warfarin, aiming for a target international normalised ratio (INR) of 2.5 and most patients also receive antiplatelet therapy. We found marked variation in the frequency of INR measurements and proportion of time outside the therapeutic INR range in our LVAD-supported patients. As part of a quality improvement initiative, home INR monitoring and a networked electronic database for recording INR results and treatment decisions were introduced. These changes were associated with increased frequency of INR measurement. We anticipate that changes introduced in this quality improvement project will reduce the likelihood of adverse events during long-term LVAD support.